Heart Wisdom Process Questionnaire
What's your cell phone number or Skype ID?
What city, state, and country do you currently live in?
What is the most severe issue you need help with?
Describe what was happening in your life before this issue. Ex: trauma, burnout, etc.
What else have you tried to fix issue? How effective?
How does this issue affect your life?
How urgent or important to resolve this issue? Rate 0 to 10(most urgent)
What does your life look like if you improve this issue?
Tell us what do you most insecure about life? How many years have you had this?
How important to address this insecurity, rate from 0 to 10?
Are you on any medications ? If so, please indicate the name and it's purpose
What is your current profession?
For best results can you commit to min. 3-6 month program (group or private session)?
What is your monthly budget for this work? Based on your budget we can recommend a practitioner that is most suitable for you.
How did you hear about us?