Bach Flower Remedies Consultation Form
The purpose of Bach Consultation is to understand your current thoughts, feelings and emotions which can be heal using Bach Flower Remedies. Please share your basic information so that we can align you for consultation and understand your concern.


Consultation Guidelines -
  • We understand that you are looking for a Consultation of Bach Flower Remedies which will help to overcome the challenges you or your loved ones are facing.
  • We can plan to meet at mutually available times over the weekend (Sat/Sun), so please confirm your feasible time by replying to this message.
  • Be informed that this will be paid consultation and fees would be Rs. 500. 
  • The cost of remedies will be charged separately post-discussion and that is optional. 
  • The consultation will be at my place or over the Phone or on Zoom.
  • We won’t allow a third person to be present during the session. 
  • All the information you will be sharing will be confidential and it will be only between you and the consultant. Information will not be shared with even your family member also.
  • We encourage you to provide true and correct information to help in a better way, still if you do not want to share something then you can politely say that you do not want to share that information instead of hiding it.
Note: Name and photo associated with your Google account will be recorded when you submit this form.
Sign in to Google to save your progress. Learn more
Email *
Your Full Name *
WhatsApp Mobile Number *
Approximate Age *
Gender *
Address / City *
Do you have any Illness or Disease? *
Mention convenient dates for consultation *
MM
/
DD
/
YYYY
Your Concern or Problem or Query *
Are you interested to Learn Bach Flower Remedies Course? *
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