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Spiritual Layer Questionnaire


FIRST CHAKRA (Root Chakra)

Do you experience a deep sense of not belonging on this planet or feeling disconnected from the world around you?

Do you experience a deep sense of not belonging on this planet or feeling disconnected from the world around you?

Have you faced significant and persistent blood-related health issues throughout your life?

Have you faced significant and persistent blood-related health issues throughout your life?

Has there been a history of bone cancer within your family?

Has there been a history of bone cancer within your family?

Do you find yourself persistently convinced that something negative or unfortunate will happen within your family?

Do you find yourself persistently convinced that something negative or unfortunate will happen within your family?

SECOND CHAKRA (Sacral Chakra)

Is it common within your family and close surroundings to experience difficulties in maintaining harmonious relationships with their partners?

Is it common within your family and close surroundings to experience difficulties in maintaining harmonious relationships with their partners?

Is there a history of sterility or infertility issues within your family?

Is there a history of sterility or infertility issues within your family?

Do you hold a belief that you are incapable of having a successful and fulfilling partnership?

Do you hold a belief that you are incapable of having a successful and fulfilling partnership?

Have you reached a point where you have given up on or lost interest in pursuing sexual relationships?

Have you reached a point where you have given up on or lost interest in pursuing sexual relationships?

THIRD CHAKRA (Solar Plexus Chakra)

Do you strongly believe that you are inherently worthless or lacking in value?

Do you strongly believe that you are inherently worthless or lacking in value?

Have you come to accept the idea that you lack physical strength or feel physically weak?

Have you come to accept the idea that you lack physical strength or feel physically weak?

Do you experience a chronic disease affecting one of the organs in your stomach or digestive system?

Do you experience a chronic disease affecting one of the organs in your stomach or digestive system?

FOURTH CHAKRA (Heart Chakra)

Have you or your family members experienced a history of heart attacks?

Have you or your family members experienced a history of heart attacks?

Is sadness a prevalent and recurring emotion among family members?

Is sadness a prevalent and recurring emotion among family members?

Has breast cancer been a frequent occurrence across generations within your family?

Has breast cancer been a frequent occurrence across generations within your family?

Have you ever had thoughts like, "I don't want to breathe anymore"?

Have you ever had thoughts like, "I don't want to breathe anymore"?

Do you feel a sense of disconnection or loss of self-identity, where you struggle to recognize who you have become?

Do you feel a sense of disconnection or loss of self-identity, where you struggle to recognize who you have become?

FIFTH CHAKRA (Throat Chakra)

Have you observed instances in your family where some of your parents or caregivers lacked self-expression capacity?

Have you observed instances in your family where some of your parents or caregivers lacked self-expression capacity?

Is poor dental health a common issue within your family, particularly among parents or other family members?

Is poor dental health a common issue within your family, particularly among parents or other family members?

Have you experienced conflicts between what your heart tells you and what your mind suggests since you can remember?

Have you experienced conflicts between what your heart tells you and what your mind suggests since you can remember?

SIXTH CHAKRA (Third Eye Chakra)

Do you find this life to be "unacceptable" or challenging to cope with?

Do you find this life to be "unacceptable" or challenging to cope with?

Has depression been a recurring issue across generations within your family?

Has depression been a recurring issue across generations within your family?

Is there a history of poor ear health (deafness) or eye health problems within your family?

Is there a history of poor ear health (deafness) or eye health problems within your family?

SEVENTH CHAKRA (Crown Chakra)

Is there a lack of acceptance or welcome towards God or spirituality within your family?

Is there a lack of acceptance or welcome towards God or spirituality within your family?

Due to a strained or negative relationship, do you feel disconnected or distant from your father?

Due to a strained or negative relationship, do you feel disconnected or distant from your father?

Do you believe that you are influenced or affected by negative entities or energies?

Do you believe that you are influenced or affected by negative entities or energies?

Do you consider yourself to be superior or better than those around you?

Do you consider yourself to be superior or better than those around you?

Thank you!