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Evolve Form

Evolve is offered selectively and is not suitable for everyone.
This form allows us to assess whether this level of care is the right fit at this time. Please answer honestly and with a little reflection. After submitting this form you will be redirected to booking a Connection Call so we can run over any questions you may have and establish that this level is the right fit for you.

Full Name

Email address

Phone number

What has led you to seek this level of care at this point in your life?

What feels most urgent or unresolved for you right now?

Have you worked with any of the following before?

Five Element Acupuncture

Psychotherapy / counselling

Somatic / body based work

Subconscious / energetic work

None of the above

What has helped and what hasn’t?

Is there anything you feel it would be important for us to know at this stage?

Evolve is delivered within a focused, practitioner-led container and requires consistency, openness, and engagement.

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I understand that Evolve is offered selectively and that submitting this form does not guarantee acceptance.

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If this level of care is recommended, I understand that it involves a significant financial commitment, typically at a four-figure monthly level, and I am comfortable with this at this time.

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At this time, I am willing and able to prioritise this work in my life.