EFT Group Questionnaire
Hello lovely! I am so happy that you will be joining me for a group tapping session. I hope that you will find the session supportive of your needs. In order to give the best service that I can, could you please share your thoughts and pour your heart out as you fill in the questions below?

You can find out more about what I do here.

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Email *
Name: *
Email *
How stressed do you currently feel on a scale of 1-10 (10 being the highest)?
*
When you think about your FFA condition, what thoughts come into your head? What is that voice telling you? Please provide as much information as possible.
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What emotions come up when you think about your FFA condition? Please select all that applies. Please rate how strongly you feel these emotions.
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1 (Affects me mildly)
2 (Affects me moderately)
3 (Affects me significantly)
Anger/Frustration
Sadness
Despair
Helpless/Powerless
Shame
Embarrassment
Disgust
Resentment
Worthless
Worry/Fear
If there are other emotions, please provide the emotion that you are feeling.
What would you like to change about your current thoughts, emotions, beliefs related to your condition? What would you rather feel instead?
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What topics would you like to explore as part of our time together to help you make these changes? Please consider goals or outcomes that you would like to achieve for yourself. For example self-acceptance, letting go, confidence etc. Or is there anything holding you back?
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How are you hoping that these sessions will help you? *
What are your expectations from me as the practitioner?
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Is there anything else you would like to share with me?
I am playing with an idea and would love your thoughts on this. 
Would you be interested in a community membership where you get access to monthly meditations, tapping sessions with support, group gatherings where you can share what you are going through, energy healing as well as talks from experts related to improving our health and beauty as it relates to Alopecia? Experts would include nutritionists, makeup artists, wig specialists, breathwork, sensual movement etc? 
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If that would be of interest, how much would you be willing to pay for this monthly membership?
By ticking the checkbox, you are confirming that you agree to undergo tapping therapy
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Required
By ticking the checkbox, you are confirming that you fully understand that the tapping treatment does not take the place of medical care. It is recommended that you see a licensed physician or health care professional for any physical or psychological ailments that you have. The tapping work can complement any medical or psychological care that you are receiving
By ticking the checkbox, you are confirming that you acknowledge that long term imbalances in the body and ingrained emotions sometimes require multiple sessions before you notice benefits.
By ticking the checkbox, you are confirming that you agree to receive occasional emails from me containing my newsletter and any special offers that I run.
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