Registration form for individual sessions with Estera Saraswati
Thank you for your interest and trust. You will receive more organisation information after filling in the form. Thank you.
Information is confidential and only for my knowledge to be of best service to you and responding well to your motivation and need. Your booking is confirmed after payment, all futher details will be provided in an email

Thank you,
Estera Saraswati

estera.saraswati@gmail.com

Full name *
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Email address *
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Gender *
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Contact number *
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Age *
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Nationality *
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Country of living *
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How many sessions do you want to book? *
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Prefered date & time of session(s) in Warsaw. Dates: 6 - 11 April 2018; Time: 9am, 12.15am, 4pm, 7.15pm *
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Face photo - post link here or please send it to my email *
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Background/ context of your situation bringing you to this session - Why are you coming? *
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Essential motivation/ Intention for the session - What do you need? what is your heart desire? *
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Do you have any experience with sexual healing or any other healing? please write more *
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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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Any episodes, or medication for, psychiatric or emotional conditions. (e.g. depression, anxiety, psychosis, bi-polar disease, obsessive compulsive behaviour, eating disorders, addictions)? *
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Are you chronically ill ? (arythmia, epilepsy, heart disorders, diabetes, hypertension, hypotension etc) *
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Do you take any medicines for any illness changing your mood or state of consciousness? which ones? *
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Have you got a session with me before? Have you done any retreat with me? *
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How do you know about these sessions? *
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Questions, comments
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