Soul Medicine⚕️Holistic Session
Please fill in this form before our session. Thank you!
Email address *
Full Name *
Date of Birth *
Place and Time of Birth *
Phone number *
Current residency *
Relationship status *
Do you have siblings? If yes, how many? *
Do you have children? If yes, how many?
Professional qualifications/studies *
Current job *
What motivated you to book a session with me? *
What are the areas in your life that you feel that you would like healing/guidance/support? *
Have you begun your Healing Journey? If yes, when? What made you start to look within? *
What are the self-knowledge tools that you know? Do you include any in your daily routine? *
Do you have any Daily Spiritual Routine? If yes, describe it. *
Can you connect with your intuition? How? *
What's your connection with the Universe/God/The Creator? What do you believe in? *
Do you connect with Nature frequently? How? *
Do you practice Meditation? If yes, when did you start? *
Do you use breathing techniques? If yes, which ones? *
Do you include self-care in your routine? If yes, what do you do? *
Are you dealing with stress/anxiety/depression? If yes, when did it start? *
Are you a Highly Sensitive Person (HSP) or an empath? *
Are you aware of any psychic gifts? For example: Clairaudience (hearing), Clairsentience (feeling), clairvoyance (seeing), clairgonizance (inner knowing) *
What's your relationship to your body? Do you listen to the signs that it gives you? *
Are you comfortable in your sexuality? Do you self-pleasure? *
Can you be at ease with your partner? Do you have pleasure while having sex? Does sex and pleasure bring up any feeling of guilt or shame? *
Do you have healthy eating habits? What's your routine? *
How is your digestion? Do you have any issues? *
Do you practice physical exercise? How many times per week? What type of exercise do you do? *
How is your sleep routine? How many hours, in average, do you sleep per Night? Do you fall asleep easily? Do you usually wake up in the middle of the night? *
Do you dream a lot? When you wake up, do you remember your dreams? Do they help you in any way? *
Do you drink alcohol? In average, what quantity and how many times per week? *
Do you smoke? If yes, how many cigarettes/packs per day? *
Do you consume any other kind of substance? *
Family precedents -Any disease in the family? Genetic diseases? *
Personal health precedents - Do you have any chronic disease? Do you have allergies? Have you done any surgery? *
Are you taking any kind of medication/doing treatment? If yes, for what? *
Do you take any supplements? For what? *
Feminine - How is your menstrual cycle? Ir/regular? Is it abundant? Do you take any contraceptive? *
In a scale from 0-10, how committed are you to take on full responsibility and charge of your own life - In a spiritual, mental, emotional and physical level - Starting from today, to live a life with more meaning, purpose and aligned with who you really are? *
Zero motivation
Totally motivated
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy