Apply to work with Clare J
TAKE YOUR LIFE BACK! Thank YOU for choosing YOU!
This is the start to your realisations and realising your dreams. Even if you just do this form and don't take it any further you should see some positive shifts in your life.
Please fill in as many of these questions possible, if you'd prefer to leave any blank that is fine as well.
This is your process but I advise you to give as much information as possible for the biggest obtainable energy shift and profound healing.
Mobile Phone Number
Date of Birth
What do you feel is holding you back in life?
What was the last obstacle in your life you have overcome?
What are you struggling with the most externally?
What is your biggest internal struggle right now?
What do you want most in life?
State one main issue in your life presently you'd consider the top priority for healing.
What is the goal you would like achieved as an out come of your treatment?
What is your biggest headache on a day to day basis?
What keeps you up at night?
What do you believe will happen if you don't get healing at this time?
Why is it important for you to get healing now?
What do you think the root cause of your issue/s is?
What things do you no longer want to experience/deal with?
What do you think is getting in the way of the results you want?
Have you had other experiences with healing?
If you could wave a magic wand what would your life look like in 6 months to a year?
Describe your deepest desire in a single sentence.
Name 3 things, if you had them, would make you feel completely fulfilled.
What is your preferred method to use, if we both decide to work together moving forward?
Whatsapp - You will need to provide your mobile number for this option
Facetime - You will need to provide your mobile number
Zoom - You will be sent an link via email to click and connect to the video call
Skype - You will need to provide your Skype name
In Person Session
Please tick to give your consent to the storing and using of your personal information, for the purpose of your on going healing and so that we may get back in touch with you. All information is confidential and never shared with 3rd parties. Thank you.
I give consent
I acknowledge that Clare Chater is a qualified shamanic practitioner and not a doctor or health care professional and that I should not ignore any advice given by my qualified doctor the NHS or my private health care professional. I understand that healing is complementary and to be used alongside professional health care and advice, not instead of. I alone am responsible for the well-being and perception of my life. I take full responsibility for my individual experience and outcome associated with all healing and beyond. I acknowledge that this healing’s intention is to provide a sacred space of trust and privacy for my healing and personal growth. I recognise that the energy healing which I would agree to receive is highly sought after and a gift. I have carefully and thoroughly read and understood this agreement. I certify that I am 18 years of age or older. Under no circumstances will Clare Chater be held responsible for my actions or circumstances. Heirs, guardians, legal representatives of Clare Chater hereby and forever release, waive, and discharge any claims against Clare Chater and any of their associates, affiliates, or family. I am aware that by ticking this box I am agreeing to the aforementioned statements. I accept these terms with gratitude for my individual free will choice.
Should I work with Clare now or in the future I confirm I have read and agree to the above statement.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service