Quantum Journey Questionnaire

Name*

First NameLast Name

Email*

example@example.com

Where do you live? (This is important to calculate time zone)*

CityState

Why are you interested in a session with me? Can choose more than one*

I want to resolve a long-term physical issue/symptom.I want to resolve a physical issue/symptom, which has just risen lately.I want to know my trajectory in life at the moment, what is that I have achieved so far in terms of inner work, where am I at the moment and what is next for me.I want to know about a recurrent dream.I want to know about a vivid, strange dream I had.I want to meet my Spirit team and learn to communicate with them.I have an affinity with Dragons and want to know more.I want to transmute traumas/programmings from this life or any past lives.I know I have an etheric Dragon in my field and I want to establish connection and know what is their purpose in my life.I want to know my StarSeed Origin and meet my Galactic Family.I want to resolve a long-term mental/emotional issue/symptom.I want to receive forgetten gifts and talents by my Ancestors.I have been feeling out of sort lately, not my usual self, more negative and easily irritating, I want to release this density and find out how I can keep my energy field strong and vibrant.Do you have gastrointestinal issues, feeling fatigued, depressed or sick with cold and flu often?Other

Have you ever had any energetic work done on you before?*

YesNoI can't remember

If yes, what type/types?

Are you currently under the care of a physician?*

YesNo

If yes, for what reason?*

If prefer not to answer, state above

Are you taking any medications? Include any prescription drugs, over-the-counter medication, birth control pill etc..*

YesNoOther

Do you drink alcohol regularly?*

YesNo

Do you use recreational drugs?*

YesNo

Thanks for taking the time to complete this questionnnaire, I will contact you in the next day or two via E-mail, please check your spam or promotion folder.