1 on 1 Client Application
Email address *
Full Name (First, Middle, Last) *
Phone Number *
Instagram Profile Link
Facebook Profile Link
Linkedin Profile Link
Website Link if Applicable
What is your current business or career?
What is calling you to work with me? What areas in your life would you like guidance and assistance? Spirituality, Love Life, Career, Physically, Health, Purpose?
What do you desire more than anything right now?
Do you have any health issues past or present? Are you taking any prescription medications? Please explain.
What are your top 3 accomplishments you have achieved in your life? How did you learn and grow from these and why do they make you feel proud?
Do any of these fears resonate with you at the moment?
Have you worked with someone in this way before? A therapist, life coach, mentor, psychic or spiritual healer? Was it one on one or a group container? Please share your experiences.
Yearly Income *
Is there anything else you feel inspired to share? Good, bad, ugly, anything goes here.
Comments and/or questions
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