New Client Request Form
Please complete and submit this form in order to be added to the New Client Wait List. Also, please note that all information provided here is kept strictly confidential with myself as the only recipient.

The current wait time is about 2-12 months, however it can greatly depend on your availability. I schedule the sessions based on when my own energy levels are optimal to accommodate the resourcing, so if I'm available at a time when you're the only client available on the list, your wait time may be substantially less! I also have a secondary sublist for urgent cases needing more immediate attention, but even this list can take several months for me to accommodate. Thank you, in advance, for your patience.

If you have any additional questions, please contact me at Adam.Intuitive@gmail.com.

First Name:
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Last Name:
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Age:
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Best Contact Number:
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Email:
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Best way to reach you for available appointment?
Location:
Please include city, state or province, and country.
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Please tell me how you found out about my services:
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Please share with me your primary reasons for seeking a consultation with a Medical Intuitive:
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Would you consider your case urgent? If so, please briefly describe your situation so I can better meet your needs:
Your answer
Please indicate specifically what kind of guidance you'd be interested in receiving from your work with me:
General Windows of Availability
Please share with me your availability in regard to an average week. I realize that schedules can change, but having your general availability with help give me an idea as to when we might be able to connect. Please make sure each window describes only times that you are available, and please be sure to put "am" or "pm" for each window. If you have two separate windows for any given day, please separate them with a "/" (for example, 11am-3pm/5pm-10:30pm, etc). Also, please enter the times in Mountain Daylight Time (MDT), as it helps me to be more efficient with scheduling. Feel free to use www.thetimezoneconverter.com to easily convert your time zone (entered on the left) to MDT (selected on the right). Thank you!
Sunday
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Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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