Individual Sessions with Georgina Peard

Thank you for your interest and trust, requesting a session with me. I wish to respond in service to your motivation and needs so this form will help you reflect and refine these before we meet, and give me some insight to prepare and hold a safe container for you. Respond as best you can and we will discuss further when we meet. This information is completely confidential and only for me to see in relation to this session. The agreements and logistics will be sent to you by email.
Thank you. I look forward to supporting you.
Georgina

georgina.peard@gmail.com / 0041 79 219 4407

Email address *
Full Name *
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Gender *
Contact phone number *
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Age *
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Nationality / Land(s) of origin *
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Where are you living now? *
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Why are you requesting this session? Short background/context of your current situation and how you are feeling. *
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What is your intention / motivation / heart desire for this session? What are you releasing / calling in / activating? *
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Do you have specific expectations? Do you have a particular type of session / type of support or touch in mind? *
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Do you have any experience with healing bodywork / shamanic or tantric bodywork / sexual healing? *
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How is your physical health? Aches & pains - chronic conditions - gynaecological issues - surgery etc. *
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Any episodes, and/or current medication for, psychiatric or emotional conditions. (e.g. depression, anxiety, psychosis, bi-polar disease, obsessive compulsive behaviour, eating disorders, addictions)? *
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Have you experienced in your life physical, emotional, mental or sexual abuse or trauma? what kind of? *
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Intimate relationships (children, partner, married, single, widow(er) etc.) *
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Are you following a spiritual path? Do you have a regular meditation and body practice (e.g. yoga, qi gong)? *
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New clients: How do you know of me?
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Questions / Comments
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