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Heart Healing & Soul Growth

Thank you for your interest in working together.
This form helps me understand your needs so I can support you in the most aligned way.
Please take a moment to fill it out, your responses will remain confidential.
After reviewing your application, I’ll follow up with you to schedule your healing Zoom call.

What is your full name?

Email Address?

About You

What drew you to this healing work?

Briefly share what called you to explore this journey.

What are the main challenges or issues you're currently facing?

This could be emotional, energetic, spiritual, or physical.

What do you hope to achieve through this work?

What would life feel like if these challenges were resolved?

Have you worked with a healer or energy worker before?

Have you worked with a healer or energy worker before?

Are there any specific areas you’d like to focus on during our sessions?

Tick all that apply.
Are there any specific areas you’d like to focus on during our sessions?

Are you available for sessions during the following times?

(Tick all that apply)
Are you available for sessions during the following times?

Additional Information

Is there anything else you’d like me to know before we connect?

Next Steps

Once you submit your application, I’ll review it and contact you to schedule your session.