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Name
First Name
Last Name
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2
Email
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3
Instagram Handle
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4
What are you wanting to achieve with working with me?
This can be physical symptoms, past traumas you are wanting to move past, healing particular beliefs and patterns that might keep playing out in your life etc.
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What do you feel like has been your biggest block, or what are you finding the hardest within your life currently?
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6
What is really lighting you up within your life right now?
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7
What are some words to describe how you want to feel after working with me?
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8
Is there anything else you want me to know?
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9
How did you hear about me?
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