Clear Vision Quest-ionnaire

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This will be a 30 minute Quest for Clear Vision to answer any questions you have, determine whether you’re a good fit for the type healing methods, individual sessions, classes, or events we offer and to get you registered/scheduled.

Email *

Date of Application: *

YYYY

Clear Vision Quest - booking intake form

Shortly after your questions have been submitted, I will be in touch with you to schedule your Clear Vision Quest.

First Name *

Last Name *

Best Email Address *

Phone #: - where can I reach you to schedule *

Best time to call or text? *

Late Morning -10am -2PM

Afternoon - 2PM- 5PM

Evening - 5PM -7PM

Other:

Just so I understand you better, tell me what prompted you to book this Clear Vision Quest *

Please send txt or email me a note when this has been submitted. Thank you 💚 Do you understand? *

Yes

Where are you in your healing journey right now? *

Are you interested in... *

An Online Class or Live Webinar

SoulFire Alchemy Session

Astrological/Tarot Reading and Channeled Messages

Shamanic/Energy Medicine Mentorship

In Person Retreat, Class, or Event

A Group Healing Retreat or Ceremony

Have me come speak or teach for your group

Other:

What do you hope to receive from the session, and WHY is that so important? *

What is your long term vison/goals for the future? *

Where on the Globe are you located? *

Anything else I should be aware of about the challenges you are facing? Or do you have questions for me? *

What type of work do you do? Is it something you love doing? If not, what would you love doing? *

How is your health doing? Are there diagnoses or symptoms I should be aware of? *

Do you have what you consider to be fulfilling and happy relationships in your life? (partner, family, children, friends...) *

What are you birth details? Date of birth, City of birth, exact time of birth. (ex. 01/10/1989, New York, NY, 6:32AM) *fill in "n/a" if you do NOT want your astrology taken into account. *

How Did I come across your Radar? (google search, referral, YouTube, Facebook, other, etc.) *

Send me a copy of my responses.

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