Blank Form (#4)Full NameEmailwhich session did you book?- Select -Trauma informed Spiritual Coaching ( 60 min)Nervous system regulation & Somatic Healing ( 60 min)Inner Child Healing session ( 60 min)Shadow work & Emotional Release ( 60 min)Hypnotherapy for Subconscious Healing ( 45 min)Manifestation & self- concept coaching (60 min)Deep Healing Combo session ( 90 min)Preferred Date / TimeWhat is your main intention for this session? You don't need to share your full story- a few words is enough.Date / TimeHow would you describe your current emotional state today? Calm/ Stable Mild stress or anxiety Emotionally sensitive Overwhelmed Not sure Any sensitivities or areas you'd like me to be aware of?Informed Consent I understand this session is coaching, hypnotherapy, somatic and/or spiritual support, not therapy or medical treatment. I take responsibility for my wellbeing and understand I may pause or stop the session at any time.Submit Form
