Connection Call Intake

Information Form

Fill out this form to book your session
Full Name*

First NameLast Name
Email*
We'll use this email to schedule your call
Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which program are you interested in*
List 2-3 issues you want to heal - add in as much details as you'd like
How ready and committed are you to heal your issues and shift your current reality?
Why do you think working with Aisha is going to help you?
Has somebody referred you?*
If you answered YES, Please list their name so we can thank them
Investment acknowledgement - The investment to work with Aisha starts at $5k for Quantum Alchemy and goes to $30k in the 1-2-1 Mentorship programs, depending on the duration of the services agreed upon. There are always customized payment plans and subscriptions offered to facilitate ease for the clients, which can be discussed on our preliminary call. Please check the box to confirm that, while there is no obligation, you understand the level of investment required, and that you are in a position to finance your decision should you decide to step into one of my bespoke programs.*

I understand and I am ready to discuss the options and commit to my healingI am not ready to invest in my healing at the moment
Any additional info you want to share
NOTE: Once we receive your submission, Aisha or one of her team members is going to respond to your inquiry within 24-48 hours to schedule your connection call. Please make sure to check your email inbox, promotions folder and spam so you don't miss her email. In case you don't hear back from her within 48 hours, please reach out directly on Instagram or via email info@aishaheals.com
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Information Form