Breakthrough Session Application

[et_pb_section bb_built=”1″ admin_label=”section” transparent_background=”off” background_color=”rgba(146,27,232,0.53)” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” background_image=”https://freshforlife.ca/wp-content/uploads/2017/04/intricate-pattern-header-faded.jpg” inner_width=”auto” inner_max_width=”none” next_background_color=”rgba(255,255,255,0.65)”][et_pb_row admin_label=”row” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” use_custom_gutter=”off” custom_padding=”0px||0px|” allow_player_pause=”off” parallax=”off” parallax_method=”off” make_equal=”off” parallax_1=”off” parallax_method_1=”off” background_position=”top_left” background_repeat=”repeat” background_size=”initial” width=”80%” max_width=”1080px”][et_pb_column type=”4_4″][et_pb_text background_layout=”dark” text_orientation=”center” use_border_color=”off” border_color=”#ffffff” border_style=”solid” custom_padding=”0px|0px|0px|0px” header_font=”Dancing Script||||” header_font_size=”70px” background_position=”top_left” background_repeat=”repeat” background_size=”initial” module_alignment=”center”]

Transformational Breakthrough Session Application

[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built=”1″ fullwidth=”off” specialty=”off” background_image=”https://freshforlife.ca/wp-content/uploads/2017/04/Crown-Chakra-cropped-left.png” transparent_background=”off” background_color=”rgba(255,255,255,0.65)” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” custom_css_main_element=”background-position: left top;||background-size: inherit;” inner_width=”auto” inner_max_width=”none” prev_background_color=”rgba(146,27,232,0.53)”][et_pb_row background_position=”top_left” background_repeat=”repeat” background_size=”initial” width=”80%” max_width=”1080px”][et_pb_column type=”2_3″][et_pb_text background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid” text_text_color=”#000000″ text_font=”Verdana||||” text_font_size=”16″ background_position=”top_left” background_repeat=”repeat” background_size=”initial”]

Taking YOUR first step to

Personal Transformation!

 

This application will help me to know more about you!

 

This Transformational Breakthrough Session takes approximately 1 hour and is valued at over $165, however it will be gifted to YOU complimentary after we have discovered our compatibility to meet your goals.  Please fill this out as carefully, honestly, and whole-heartedly as possible.  Anything you share will be kept between us and completely confidential.

[/et_pb_text][/et_pb_column][et_pb_column type=”1_3″][et_pb_image src=”https://freshforlife.ca/wp-content/uploads/2019/04/brooke-cagle-52215-unsplash.jpg” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” animation=”left” sticky=”off” align=”left” force_fullwidth=”off” always_center_on_mobile=”on” use_border_color=”off” border_color=”#ffffff” border_style=”solid” animation_style=”slide” animation_duration=”500ms” animation_intensity_slide=”10%” animation_direction=”left” show_bottom_space=”on”]

[/et_pb_image][/et_pb_column][/et_pb_row][et_pb_row background_position=”top_left” background_repeat=”repeat” background_size=”initial” width=”80%” max_width=”1080px”][et_pb_column type=”4_4″][et_pb_contact_form email=”crystalheartchakra@gmail.com” title=”Transformational Breakthrough Session” success_message=”Thank you so much for taking the FIRST step necessary in furthering your path of personal progression. All of your info will be kept confidential between you and me. I look forward to guiding you to live the life you truly desire!” use_border_color=”off” button_letter_spacing_hover=”0″ border_radii=”on|0px|0px|0px|0px” _builder_version=”3.22.4″ submit_button_text=”Submit Application” text_shadow_horizontal_length=”text_shadow_style,%91object Object%93″ text_shadow_vertical_length=”text_shadow_style,%91object Object%93″ text_shadow_blur_strength=”text_shadow_style,%91object Object%93″ title_text_shadow_horizontal_length=”title_text_shadow_style,%91object Object%93″ title_text_shadow_vertical_length=”title_text_shadow_style,%91object Object%93″ title_text_shadow_blur_strength=”title_text_shadow_style,%91object Object%93″ form_field_text_shadow_horizontal_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_vertical_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_blur_strength=”form_field_text_shadow_style,%91object Object%93″ button_text_shadow_horizontal_length=”button_text_shadow_style,%91object Object%93″ button_text_shadow_vertical_length=”button_text_shadow_style,%91object Object%93″ button_text_shadow_blur_strength=”button_text_shadow_style,%91object Object%93″ z_index_tablet=”500″ title_level=”h2″ form_field_text_color=”#424242″ saved_tabs=”all” custom_message=”Name: %%name%%||et_pb_line_break_holder||Email: %%email%%||et_pb_line_break_holder||Goals: %%goals%%||et_pb_line_break_holder||Feelings: %%feelings%%||et_pb_line_break_holder||Blockages: %%blockages%%||et_pb_line_break_holder||Healers: %%healers%%||et_pb_line_break_holder||Budget: %%budget%%||et_pb_line_break_holder||Commitment: %%commitment%%||et_pb_line_break_holder||Receiving Help: %%receivinghelp%%||et_pb_line_break_holder||Anything else: %%anythingelse%%”][et_pb_contact_field field_title=”Name” field_type=”input” field_id=”Name” required_mark=”on” fullwidth_field=”off” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ /][et_pb_contact_field field_title=”Email Address” field_type=”email” field_id=”Email” required_mark=”on” fullwidth_field=”off” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”feelings” field_title=”What are the predominant feelings and emotions you experience on a daily basis? (ex- anxiety, depression, apathy, etc)” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”goals” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” field_title=”What are your personal and professional goals? What work have you done so far towards achieving/manifesting them?” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”blockages” field_title=”What do you believe are the major blockages that you are currently experiencing?” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”healers” field_title=”Have you ever worked with a professional healer, coach, mentor, etc? If so, what were your results?” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”budget” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” field_title=”Do you set aside a monthly budget for personal transformation and self-care? (ex- counselling, healings, exercise, courses, etc)” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”commitment” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” field_title=”On a scale of 1-10, how ready to make the changes necessary to achieve your goals? Please explain.” _builder_version=”3.22.4″ /][et_pb_contact_field field_id=”receivinghelp” field_title=”On a scale of 1-10, how open are you to receiving in your life, including assistance, guidance, or gifts? Please explain.” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22On a scale of 1-10, how open are you to receiving in your life, including assistance, guidance, or gifts? Please explain.%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22On a scale of 1-10, how open are you to receiving in your life, including assistance, guidance, or gifts? Please explain.%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22On a scale of 1-10, how open are you to receiving in your life, including assistance, guidance, or gifts? Please explain.%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22name%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ link_option_url_new_window=”off” use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” background_video_pause_outside_viewport=”on” form_field_text_shadow_style=”none” form_field_text_shadow_horizontal_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_vertical_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_blur_strength=”form_field_text_shadow_style,%91object Object%93″ border_radii=”on||||” box_shadow_style=”none” box_shadow_horizontal=”box_shadow_style,%91object Object%93″ box_shadow_vertical=”box_shadow_style,%91object Object%93″ box_shadow_blur=”box_shadow_style,%91object Object%93″ box_shadow_spread=”box_shadow_style,%91object Object%93″ hover_transition_duration=”300ms” hover_transition_delay=”0ms” hover_transition_speed_curve=”ease” /][et_pb_contact_field field_id=”anythingelse” field_title=”Is there anything else you would like me to know about you?” field_type=”text” required_mark=”on” fullwidth_field=”on” form_field_font_select=”default” form_field_font=”||||” use_border_color=”off” border_style=”solid” _builder_version=”3.22.4″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Is there anything else you would like me to know about you?%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Is there anything else you would like me to know about you?%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Is there anything else you would like me to know about you?%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22name%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ link_option_url_new_window=”off” use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” background_video_pause_outside_viewport=”on” form_field_text_shadow_style=”none” form_field_text_shadow_horizontal_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_vertical_length=”form_field_text_shadow_style,%91object Object%93″ form_field_text_shadow_blur_strength=”form_field_text_shadow_style,%91object Object%93″ border_radii=”on||||” box_shadow_style=”none” box_shadow_horizontal=”box_shadow_style,%91object Object%93″ box_shadow_vertical=”box_shadow_style,%91object Object%93″ box_shadow_blur=”box_shadow_style,%91object Object%93″ box_shadow_spread=”box_shadow_style,%91object Object%93″ hover_transition_duration=”300ms” hover_transition_delay=”0ms” hover_transition_speed_curve=”ease” /][/et_pb_contact_form][/et_pb_column][/et_pb_row][/et_pb_section]

Don't miss out!

Subscribe To Our Newsletter

Sign up for our newsletter and stay up-to-date with events, contests, giveaways, and more!