Intake Form: Dark Flowering and Miasma Clearing
First Name
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Last Name
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Your Email Address
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example@example.com
City and Country You are From
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What Time Zone Will you Be in, if we do have a Zoom Call? I can work with you if you would like to meet in person. Let me know by Email.
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What Language(s) Do you Speak?
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Do You Speak or Read English?
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What Prompted You to seek out the Miasma Clearing Service?
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What are you Hoping for with the Misama Clearing?
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Are you Affiliated With a Religion? Are You an Active Member?
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Where are you in Your Spiritual Journey? Experiences you would like to share.
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What Questions do you have about the Miasma Clearing, if any?
Do you have any Health issues I should be aware of?
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Do you have any Mental Health issues currently or in the past?
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Are you being, or have you been attacked in a non-physical way or a physical way? If so please elaborate.
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Is there anything else you want to share with me prior to me doing the clearing?
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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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