Energetic Allergy Healing Session Request

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Please complete this form and I will be in touch with you very soon. ** If you don't see an email from me within a couple of days please check your junk folder and make sure to add kalilahealingarts@gmail.com to your contact list to ensure you receive all emails. ** Always feel free to email me as well.

Today's Date *

YYYY

First and Last Name *

Phone Number *

Text Ok? *

Yes

Email *

Preferred method of communication *

Phone Call

Text Message

Sessions Interested In *

Single Session

Three Session Package

Six Session Package

Required

Are there better days of the week and times for us to have our consultation meeting via Zoom? *

I understand that I am a co-creator in this healing and am able to commit to listening to the recordings several times in order to facilitate my healing. *

Yes

Maybe

I believe that distance energy work is effective. *

Yes

Maybe

I am ok with the fact that most of this work is done remote, meaning not face-to-face or live online. *

Yes

Maybe

What are the symptoms you are experiencing that you would like to work on improving? *

I am so excited to work with you! Is there anything else you would like me to know before we meet? *

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