Apply to work with Clare J
TAKE YOUR LIFE BACK! Thank YOU for choosing YOU!

This is the start to your realisations and realising your dreams. Even if you just do this form and don't take it any further you should see some positive shifts in your life.

Please fill in as many of these questions possible, if you'd prefer to leave any blank that is fine as well.
This is your process but I advise you to give as much information as possible for the biggest obtainable energy shift and profound healing.  
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Email *
Name *
Mobile Phone Number
Date of Birth
Occupation
Medications & supplements taken
What do you feel is holding you back in life?
What was the last obstacle in your life you have overcome?
What are you struggling with the most externally?
Clear selection
What is your biggest internal struggle right now?
What do you want most in life?
State one main issue in your life presently you'd consider the top priority for healing.
What is the goal you would like achieved as an out come of your treatment?
What is your biggest headache on a day to day basis?
What keeps you up at night?
What do you believe will happen if you don't get healing at this time?
Why is it important for you to get healing now?
What do you think the root cause of your issue/s is?
What things do you no longer want to experience/deal with?
What do you think is getting in the way of the results you want?
Have you had other experiences with healing?
Clear selection
If you could wave a magic wand what would your life look like in 6 months to a year?
Describe your deepest desire in a single sentence.
Name 3 things, if you had them, would make you feel completely fulfilled.
What is your preferred meeting, if we both decide to work together moving forward?
Clear selection
Privacy Policy and GDPR *
Please tick to give your consent to the storing and using of your personal information, for the purpose of your on going healing and so that we may get back in touch with you. All information is confidential and never shared with 3rd parties. Thank you.
Required
Confidentiality Agreement *

I acknowledge that Clare J is a qualified Coach & Shamanic Practitioner and not a doctor or health care professional and that I should not ignore any advice given by my qualified doctor the NHS or my private health care professional. 

I alone am responsible for the well-being and perception of my life. I take full responsibility for my individual experience and outcome associated with all coaching/healing and beyond. I acknowledge that this process’ intention is to provide a sacred space of trust and privacy for my personal growth. I recognise that the energy healing which I have agreed to receive is highly sought after and a gift. I have carefully and thoroughly read and understood this agreement. I certify that i am 18 years of age or older. Under no circumstances will Clare J be held responsible for my actions or circumstances. Heirs, guardians, legal representatives of/Clare J or Shamanic Directions hereby and forever release, waive, and discharge any claims against Clare J or Shamanic Directions and any of their associates, affiliates, or family.  I am aware that by ticking this box is confirming as my signature and I am agreeing to the aforementioned statements. I accept these terms with gratitude for my individual free will choice.

I understanding that this information is sacred and not to be taught, shared, sold on or passed on carelessly. I have carefully and thoroughly read and understood this agreement.

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