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Emotional Energy Healing Survey
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* Indicates required question
What is your name?
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Your answer
What is your email address?
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Your answer
What reoccurring emotions do you experience?
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Your answer
What triggers you emotionally?
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Your answer
Where do you become especially reactive in your life?
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Your answer
Where do you experience physical pain or tension?
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Your answer
How is your drama serving your ego?
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Your answer
What are you resisting?
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Your answer
Where are you struggling in your life?
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Your answer
What feelings lie beneath your experience of your problem?
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Your answer
Where do you need to be more patient with yourself?
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Your answer
What areas in your life must you recommit to?
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Your answer
Would you like a recording of the healing session for only $11 (paid via Venmo or Paypal) **Will be $25 after call is Live
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Yes
No
If you would like a recording please leave your Venmo Name or Paypal Email along with a phone number to receive texts
Your answer
Any questions, concerns or comments about this healing session?
Your answer
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