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?
What concerns or fear do you have about how this issue affects your life?
How urgent or important to resolve this issue? Rate 0 to 10(most urgent)
What is the life look like if you can improve this issue?
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?
How did you hear about us?