Spiritual Care Application
Thanks for your interest in working me. Please take a moment to tell me about your needs and goals for our work together. Also, be sure to check the modalities and services you're interested in. I'll follow up promptly to schedule an exploratory (no cost) call.
Email address *
First Name *
Your answer
Date of Birth *
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Location of Birth + Exact Time (if known) *
Your answer
Your time zone and phone # for when we schedule an exploratory call. *
Your answer
Your primary needs and goals are for our work together. *
Your answer
What services + modalities are you interested in? Check all that apply. *
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Which option best suites you... *
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Lastly, most clients come to me by referral. Please tell me who sent you or how you found me. *
Your answer
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Asgardian Coaching & Consulting, LLC.