Name
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First Name
Last Name
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Phone Number
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-
Area Code
Phone Number
Email
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example@example.com
Instagram Handle
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What intrigued you to apply?
What do you struggle with currently in your health, life, and/or relationships?
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Chronic illness or pain
Money flow, abundance, and feelings of scarcity
Setting & enforcing boundaries
Inconsistency
Control
Unable to get over your ex
Always putting more effort into your relationships
Feeling unfulfilled/exhausted
Feeling insecurity and/or not trusting
Other
Please give me a brief history of your relationships - it could be your past romantic relationships, how your family was growing up, your friendships, etc.
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If I helped you achieve one thing in the next 90 days, what would it be?
When you visualize yourself with clear & magnetic energy - who is this person, and what does this feel like to you? Be as specific as possible!
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Are you willing to invest financially into this work?
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Yes
No
Do you live in Houston, Texas? If so, are you interested in in-person body work sessions, personalized sound baths and healing, and events?
Yes! I love in person
I am more interested in online
Hybrid in-person and online is interesting to me
Please keep me updated on group events in the Houston area
If you live outside of Houston, TX and would be interested in in-person healing, where do you live? (Would you also like to see pop up events in your area?)
If yes, my 1:1 work starts at $1,000/month. Note this isn't just sessions, it complete energetic upgrades and deep identity-resetting work. Are you prepared to make that level of investment? (If not, it is ok, I simply want to direct you in the best direction!)
Yes
I am more likely to invest in very transformative group work (starting at $250/month, and only open in specific cohorts)
I want to explore some smaller sessions
Do you have any questions for me?
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