Getting To Know You Survey
Please fill out all of the questions to receive your free ticket to the Get Unblocked Chakra Clearing! This offer is on for a limited time.
Sign in to Google to save your progress. Learn more
Thank you so much for filling out this anonymous survey to help me understand you, your desires and how I can help you.

This will take about 10 minutes - I really appreciate your time!
How did you originally find me? *
Required
What are you looking to manifest the most right now? What is your top-priority desire? *
Required
What would be the second most important, would you say? *
Required
What are the biggest obstacles to creating your dream life you face in you daily life? (check all that apply) *
Required
What would you say is holding you back? *
What would you love me to talk more about on the podcast? Tell me all of your ideas!
*

Which of the following interest you most if you were to join one of my containers? 

(choose all that interest you)

*
Required
Right now, how much do you relate to the following statement:

"I have made a lot of progress and have changed so much in my life. I am not where I used to be but I am not yet where I am going. I am in an "in-between" stage."
*
How much do you relate to the following statement:

"Things are breaking down, stuck or stagnant and I need help figuring out WTF is going on and what life is trying to tell me"
*
In the next section, I am curious how much certain topics interest you. 

Please rate them 1-10. 10 is very interested, 1 is not very interested

How interested are you in healing beliefs + the subconscious to manifest?

*

How interested are you in focusing on loving yourself more and treating yourself better?

(self love + self care)

*

How interested are you in learning more about Awakening - what it is, how to navigate it, tools fo Spiritual awakening etc.

*

How interested are you in learning about manifesting money?

*

How interested are you in manifesting health or body changes?

*

How interested are you in developing your intuition and connection to Spirit / your spirit team?

*

How interested are you in manifesting big, massive goals?

*

How interested are you in learning how to quantum leap?

*

How interested are you in uncovering your Souls Purpose?

*

How interested are you in creating a purpose-led business?

*

How interested are you in exploding the business you have already?

*
Whether it's the podcast, Instagram, my programs or personal mentorship - what do you come to me for? What topics or medicine do you seek from me?
*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy