1:1 Chakra Exploration Balancing Session | Questionnaire
Thank you for taking the time to answer these questions. This assessment will provide me with insight into your current desires and help to identify the chakra focus for our Chakra Balancing session together. This session focuses on unpacking any chakra blockages that are presently impacting your life. Whether you are brand new or deep into chakra work, I support you with identifying imbalances and offering guidance to create a targeted action plan to help you heal and align with your most empowered, liberated & activated self.
1. Name
First Name
Last Name
2. Email
example@example.com
3. How familiar are you with the chakra body & signs of imbalance?
Not at all familiar
A little bit familiar
I have a general understanding
I am highly familiar & attuned
4. What are you MOST wanting support with? (Select up to 2 boxes)
Transforming fear and finding my center during changes & instability
Processing emotional trauma, releasing limiting beliefs & negative stories
Cultivating more purpose, confidence & authentic embodiment
Strengthening self-love & opening my heart
Releasing blockages for self-expression & speaking my truth
Building tolerance for challenges & differentiating intuition vs. mind
Connecting deeper with my Higher Self, calling, or meaning
5. What are you needing more of at this time in your life?
Grounding, Trust & Vitality
Self-worth, Pleasure & Creativity
Purpose, Identity & Empowerment
Self-love, Acceptance & Compassion
Self-expression, Conscious Communication & Embodiment
Clarity, Understanding & Vision
Faith, Hope & Spiritual Connection
6. What else are you hoping to receive from our session together?
7. In what area or aspect of your life are you desiring change? How do you want to feel?
8. What is your time zone?
Submit
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