Form

Your Name *

First Name Last Name

Your E-mail *

Phone Number *

- Area Code Phone Number

Age *

Todays Date *

What's going on in your life right now that you're seeking support? *

What religion or Spiritual discipline did you grow up with and what is your current Spiritual Practice if any?

Do you meditate? If so what type of meditation do you practice?

How often do you spend time in meditation?

Are you familiar with different prayer techniques?

How often do you spend time in Prayer ?

What would you say is your biggest challenge in connecting with others?

What would you say is your biggest challenge in connecting with yourself?

What would you say is your biggest challenge regarding connecting to God/source? *

Describe your family life.

Describe your friendships or lack of friendships?

On scale of 1-10 (1 being the lowest and 10 highest) How committed are you to being willing to FULLY LOVE yourself without apology? If less than 10 what are the three biggest reasons that stand in the way? *

On scale of 1-10 (1 being the lowest and 10 highest) what is your commitment level to invest in the (A) Time, (B) Money,(C) Intimate self-reflection and (D) Spiritual excavation to really connect deeply with source for a life filled with Joy , Peace and Abundance *

Is a lack of connection to source keeping you from living the life you truly want? *

Has your lack of a true and authentic relationship with God left you fearful, insecure or self doubting in your life? *

What do you want to feel when you connect intimately with source? *

On average how much money to do invest in yourself through either personal development classes, retreats workshops, etc ? *

Which of the personal development events do you find most rewarding? Please list in order of importance. The most import and rewarding list first.... Retreats, workshops, classes, personal coaching......

What would your life be like if you depend your relationship with God/Source and truly felt loved, supported and fulfilled? *

What quantum leap (spiritual or otherwise) would you say you have achieved that you are proud of? *

Best Contact number

- Area Code Phone Number

Best time of day to connect? Please give a 2-3 hour call back window. *

KiMani Divine Discovery Session