ShaaniCreates Consulting Form
Questionnaire for clients regarding ShaaniCreates Consulting Services. Your information is submitted securely and will not be shared with a third party.
Name (First Middle Last)
Date of Birth
Current Mailing Address
Telephone Number (xxx-xxx-xxxx)
How did you find out about ShaaniCreates?
Search engine other than Google
Facebook, Instagram, Twitter or another social media site
Friend, Family Member
Are you teachable?
How may we help you today? Please describe the assistance you need today.
Are you available to meet with ShaaniCreates during a video conference? Visit ShaaniCreates.com/connect to read about what to use.
I understand ShaaniCreates consulting services does not replace medical care or treatment
Yes. I agree.
No. I do not agree. I am not interested in ShaaniCreates consulting services at this time.
A copy of your responses will be emailed to the address you provided.
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