ShaaniCreates Intuitive Reading Form
Questionnaire for clients regarding ShaaniCreates Intuitive Readings. Your information is submitted securely and will not be shared with a third party.
Sign in to Google to save your progress. Learn more
Email *
Name (First Middle Last) *
Date of Birth *
MM
/
DD
/
YYYY
Time of Birth (if known)
Time
:
Place of birth (City, State, Country) *
Current Mailing Address *
Telephone Number (xxx-xxx-xxxx) *
How did you find out about ShaaniCreates? *
Relationship Status *
Are you happy? *
Do you have anger issues? *
Do you love yourself? *
Do you forgive yourself? *
Are you teachable? *
What type of intuitive reading are you interested in? You may select more than one. *
Required
Have you had an intuitive reading before? *
How may we help you today? Please describe the assistance you need regarding an intuitive reading. *
Are you available to meet with ShaaniCreates during a video conference? Visit ShaaniCreates.com/connect to read about what to use.
Clear selection
I understand ShaaniCreates consulting services does not replace medical care or treatment *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy