Psychic Protection Questionnaire for your session with Maya Zahira

Welcome to Psychic Protection Sanctuary with Maya Zahira!

Please fill out the questions below. This is a very thorough questionnaire, and will assist Maya in obtaining a clear understanding of your situation and how she can best support you.

Disclaimer: Please be advised that Maya Zahira is not a doctor, therapist, lawyer, or financial adviser. As such, no part of your session should be interpreted as a replacement for medical diagnosis or treatment, or professional financial or legal advice. If you are experiencing a medical or psychiatric emergency, or if you feel you are in danger, please immediately contact 911 or your medical professional.

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Email *

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Phone *

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Possible Causes / Vulnerabilities to Psychic Attack

The following are a broad range of factors that can (but do not always) make a person more vulnerable to psychic attack or unwanted paranormal activity.

Please check all that apply. *

Have you ever experienced physical or emotional abuse at any time in your past?

Have you ever experienced sexual abuse at any time in your past?

Have you ever been sexually assaulted?

Do you have a history of mental health issues including depression or anxiety?

Do you have a history of serious psychiatric issues?

Have you ever attempted suicide?

Have you recently experienced any type of personal trauma or loss?

Have you ever been the victim of a crime?

Have you been in a minor or major car accident?

Have you ever committed a crime?

Have you ever been incarcerated?

Have you experienced chronic or acute illness?

Have you had a major surgery or major medical procedure in the past?

Do you use recreational drugs, or have you used them in the past?

Do you have any type of addiction, including drugs, alcohol, food, sex, gambling, or etc.?

Do you have issues with bouts of anger, aggression, or violent outbursts?

Do you have a lot of stress in your home or work environment?

Would you say there's a lot of drama in your life right now?

Do you have difficulty setting and maintaining boundaries with others?

Have you ever done "ghost hunting" or paranormal investigations as a hobbyist or professional?

Have you ever gone on a "haunted ghost tour" at a location that was known to be haunted?

Do you have any ancestors who practiced Satanism or the Dark Arts?

Have you been a victim of ritual abuse?

Have you ever been a member of a religious cult?

Have you ever used a Ouija board to communicate with spirits?

Have you ever worked with black magick, hexes, or curses to cause harm to others?

Have you intentionally summoned demons or evil spirits, just for fun, or to do your bidding?

Have you ever purposely opened a portal so that spirits could pass through?

Do you believe you have had contact with extra-terrestrial beings?

To your knowledge, do you believe you've been psychically attacked at any point in the past?

Do you feel there is a person or people in your life who are jealous of you?

Have you ever been attacked (physically, psychologically, sexually, or etc.) by an evil spirit or demon?

Are you a psychic medium (see or sense spirits)?

Are you a spiritual channel (one who receives messages from spiritual beings, ET's, or etc.)?

Are you an energy healer, faith healer, Reiki practitioner, shamanic healer, or other lightworker?

Have you ever used substances (like ayahuasca, DMT, etc.) to create altered spiritual states?

Are you extra sensitive to the energies and feelings of those around you?

Are you able to see things that other people cannot see?

Is your life purpose rooted in spreading light and helping others?

Would you say that you are deeply spiritual and devout in your love for the Divine?

Do you feel you have some unhealthy lifestyle habits? (like smoking, junk food, soda, lack of sleep)

Other:

Required

Additional Notes and Details Regarding Possible Causes of Psychic Attack

Your answer

Possible Indications / Symptoms of Psychic Attack

The following can be possible indicators of a psychic attack. Keep in mind that many of these things can have natural causes, so be sure to rule out obvious causes first before assuming you're under attack. With that said, many people second guess themselves and brush off real symptoms of psychic attack until it is too late. It's better to be safe than sorry!

Please check all that apply. *

Nightmares (especially dreams of being attacked or chased)

Unusual dreams of a sexual nature

Fear of going to sleep

Feeling of extreme fear or dread

Mental disorientation

Forgetfulness, trouble focusing, or 'brain fog'

Moodiness or on edge

Feeling angry for no apparent reason

Apathy or lack of interest in life

Anxiety or worry

Sudden onset of depression

Obsessive thoughts

Having unusually dark thoughts that don't seem to be your own

Nervous exhaustion or mental breakdown

Feeling like you are going crazy and/or questioning your sanity

Worsening of addictive behaviors

Loss of self-confidence

Self-destructive thoughts, or suicidal thoughts

Self-harm behaviors

Substance abuse, or relapse abuse or other addictive behavior

Thoughts, feelings, or urges that are uncharacteristic for you

Suddenly acting out of character

Trouble sleeping

Coughing, choking, or feeling like you cannot breathe

Dizziness or vertigo

Headache

Stomach ache, nausea, or cramping

Accident-prone

Car accient or other significant accident

Unexplainable exhaustion

Sudden onset of illness (with an explainable cause or diagnosis)

Sudden onset of mysterious illness that evades diagnosis

Unexplainable pain in all or part of your body

Sexual impotence (males)

Change in appetite, no appetite, or overeating

Wake up in the morning feeling drained

Unexplainable bruises, scratches, or marks on the body

Sleep paralysis

Feeling of weight on your chest

Foul stench from unknown origin

Feeling icy-cold for no apparent reason

Feeling like something is touching you

Feeling of being physically attacked, molested, or sexually assaulted by an unseen force

Hair stands up on the back of your neck

Chills down your spine

Feeling like you are being watched

Missing time (a gap in memory for a certain time period)

Reality seems to bend. Odd things occur that make no sense.

Unusually bad luck in finances, relationships, career, or other areas of life

Upsurge of drama in your life

Challenging life situations such as divorce, loss of job, death in the family, etc.

Unusual amount of interpersonal conflict in your life

Bank account has been hacked, identity theft, bankruptcy, or loss of a large sum of money

A loved one or pet becomes unexplainably ill or dies

Items going missing from home

Electronic devices breaking or acting strange

Lights flashing

Odd temperature fluctuations in the home, especially cold spots

A breeze or draft for no known physical reason

Hearing unusual sounds in the home, including knocking, creaking, disembodied voices, et

Seeing apparitions--ghosts, demons, or other spiritual beings

Physical objects moving for no explainable reason

Feel uncomfortable in one part of your home

Seeing shadows

Seeing something out of the corner of your eye, but when you turn to look, nothing is there

Other:

Required

Additional Notes and Details Regarding Symptoms of Psychic Attack

Your answer

Other Additional Notes

Your answer

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