Restoring Harmony Immersion Waiting List
Congratulations! I am so excited and proud of you for taking the first step to beginning to live YOUR Rich, Authentically Aligned, Wholesome life. Please complete the form below. This will allow me to get to know you a bit more and see what goals you are looking to reach while in this transformational container.
Email *
Name *
Email Address *
Which program are you most interested in? *
Required
What is your primary area of concern that brought you here? *
What was it about this particular program that had you reach out? *
Are you the primary decision maker related to your health? If not, who helps you make those decisions? *
Are you under the supervision of a medical professional? If so, are you working with him/her/they regarding anything specific? *
What treatments, therapies, or modalities have you tried with your primary area of concern prior to arriving here? *
What are the specific health goals that you are desiring to achieve through our work together and why is it important for you to reach them? *
Are you 110% ready to commit to yourself and your goals? *
Do you have the means (time, bandwidth, financial, etc) necessary to invest in yourself and your goals? *
Is there anything else you would like me to know about you as we prepare to get you into this life transformational program?

Thank you and welcome to the Restoring Harmony Immersion! We will be in touch as your time to begin draws closer.
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