Phone Number

State and City of Residence

What is your intention for receiving my guidance?

What is your number one pressing problem or concern right now that you would like help with?

What are the three biggest obstacles preventing you from having what you want in your life?

Are you currently taking any medications for mental health issues?

Do you have any drug or alcohol related addictions?

Have you ever received personal guidance, coaching or therapy?

If yes, have you worked with a life coach, spiritual guide, psychologist, psychiatrist, and/or therapist?

When and length of time which each.

What was your personal experience with each type of support?

How would you describe your personality?

Why are you drawn to me for guidance?

Are you willing to invest in receiving support and guidance right now?

How did you find me?