lavender & TIME Consultation Questionnaire
First / Last Name *
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Email *
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Address (City, State) *
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Phone *
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Preferred Method of Contact *
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What is the biggest challenge you are facing right now? *
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What are three goals you have for yourself for the next 6 months? *
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Name the key people in your life and what they provide for you. *
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Tell me about your experiences with coaching, hypnosis, and other therapy modalities. *
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