Heart Wisdom Process Questionnaire
What's your cell phone number & Skype ID?
What city, state, and country do you currently live in?
Which area of your life would you like to see improve ? (add the top 3)
Write specific goals in those life areas that you mentioned above.
What is blocking you from achieving those 3 goals?
What beliefs can you think of is blocking from achieving your goals? If you know, what experiences created those beliefs?
What would life look like if those beliefs are removed?
What has been a repeating pattern that you've noticed in your life ?
If you can resolve, heal, or improve one thing in your life, what would it be ?
Where do you most commonly feel pain in your body? When you are stressed or unhappy, where do you feel pain or tension?
Are you on any medications ? If so, please indicate the name and it's purpose
Please list your previous surgeries and the year it was done. (include wisdom teeth, abortion, etc)
What do you currently do for work ? Do you enjoy it ?
What best describes your situation?
I want only one session for immediate relief
I want to resolve the deepest subconscious programmings with the series of sessions
Have you done personal development work before ? If so, please list your previous work and year of involvement.
How committed are you to investing in yourself for a lasting breakthrough so you can live your best life possible ?
Who has been your mentor up until now ?
How did you hear about us?
If it were one year from today, what would have to happen to allow you to say, "This was the best year yet!"