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Womb in Bloom - 1:1
All the information shared here is private and confidential. Please answer each question with intention and transparency.
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Email
*
Your email
Name and last name
*
Your answer
Phone Number
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Your answer
Instagram handle (optional)
Your answer
Are you currently in any type of contraceptive method?
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Yes
No
Which one and for how long?
Your answer
Have you been diagnosed with a womb related condition?
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Yes
No
Explain as much as you feel comfortable.
Your answer
How is your Moon Time? Pain, length, and abundance of flow.
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Your answer
What do you do for a living?
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Your answer
Do you currently exercise? If so, how many times a week?
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Your answer
How do you feel about your physical appearance?
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Your answer
Are you looking to conceive?
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Yes
No
In the future
What is your intention for our time together?
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Your answer
How did you learn about Womoon Healing?
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Soulcial Media
A friend
In-Person event
Other:
Is there anything else you would like to share?
Your answer
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