Intake Form For: 12D Ascension Blueprint, and The Healers Blueprint
First Name
*
Last Name
*
Your Email Address
*
example@example.com
City and Country You are From
*
What Time Zone Will you Be in For our Live Session(s)?
*
What Language(s) Do you Speak?
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Do You Speak or Read English?
*
Please Honestly Respond to the Following Questions: If you answer "No" to a question and would like to discuss this with me, then we can have a brief 15 min Zoom call to make sure the Realignment is right for You. Please comment at the end of this form if this is the case. Thank you
I have a meaningful, loving relationship with our Creator.
Yes
No
I engage in daily Spiritual practices in which I consciously make a connection with our Creator and my Higher Self. (such as a meditation practice)
Yes
No
I seek to Serve others.
Yes
No
I make improvements and catch myself when my behavior and actions are not loving. I make conscious choices to change this aspect of myself to be more loving to others.
Yes
No
I ask for forgiveness from the Individuals I knowingly or unknowingly hurt or harmed in any way.
Yes
No
I forgive those who have harmed me.
Yes
No
I love myself. I am loving, nurturing, and attentive to all life.
Yes
No
I allow other Adults to make their own choices, as we live in a freewill Universe.
Yes
No
I am in gratitude and appreciation for all I have in this NOW moment.
Yes
No
I chose to be the embodiment of the highest aspect of myself, while here on this Earthly Plane.
Yes
No
Are you being, or have you been attacked in a non-physical way? If so please elaborate.
*
Is there anything else you want to share with Me prior to our Live meeting?
Please Upload Photo. You may also email lisa@yourlightbodyalchemist.com with an attachment and explanation of your service. By uploading your photo or photos you are giving YLBA permission to do testing and analysis with them.
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