Energy Scan Application

Distance Energy Work, done with the right healer, can help you gain results fast. When you find the right energy healer who is a good fit for you, your growth begins to accelerate at a much higher level. By filling out this questionnaire, you'll allow me to learn a little bit more about you, and see if we might be a good fit. This will also enable us to make better use of our time together when we're on the phone. Be as honest and as thorough as possible.

* Indicates required field

Name *

First

Last

Email *

If you are in a country other than the US, do you have access to Skype? *

Yes No I prefer to use my phone

What area of your life would you like to see cleared up right now? *

When this area is cleared, what will your future look like? *

Have you ever worked with a distance energy healer before? *

If so, what were the results like for you? *

If you have a spiritual orientation, can you please describe it to me? *

Are you currently taking any prescription meditations designed to alter mood or behavior? *

Are you currently under psychiatric care, and if so, for how long? *

If we were to move forward with working together, is private, one-on-one more your style, or do you prefer group coaching or home-study alone? *

Private, one-on-one Group Coaching I prefer home study alone

Submit

Thank you! You will now be led to the booking calendar, and then can expect to receive a confirmation email for your appointment within 24-48 hours. Mahalo ~