Name

Email Address

What are the predominant feelings and emotions you experience on a daily basis? (ex- anxiety, depression, apathy, etc)

What are your personal and professional goals? What work have you done so far towards achieving/manifesting them?

What do you believe are the major blockages that you are currently experiencing?

Have you ever worked with a professional healer, coach, mentor, etc? If so, what were your results?

Do you set aside a monthly budget for personal transformation and self-care? (ex- counselling, healings, exercise, courses, etc)

On a scale of 1-10, how ready to make the changes necessary to achieve your goals? Please explain.

On a scale of 1-10, how open are you to receiving in your life, including assistance, guidance, or gifts? Please explain.

Is there anything else you would like me to know about you?