Enquiry Form: Holistic Wellness
Please fill out this form to help me understand your wellness goals and needs.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Which trauma-informed offerings would you like to explore? (Multiple selection)
Fascia Manoeuvre Coaching
Yoga, Breathwork and Meditation
Reiki-infused Sound Immersion
Reiki Therapy
Sister Empowerment Mentorship
Blended Approach (Various as above)
What are your inspirations for seeking holistic wellness support at this time?
How do you currently feel in your mind, body and energy? Do you actively participate in practices to achieve balance of mind, body and soul? Please specify.
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Are there any health challenges, injuries, or past emotional/trauma experiences you’d like to mention?
What kind of coaching feels most aligned for you right now? 1-12 Single Sessions / 3-Month Container / 6 or 12 Month Mentorship
What are your intentions for our coaching work together? How would you like to feel at the end of our sessions?
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Would you like to arrange a free consultation? If so, please specify a date and time below.
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