Consultation Book Consultation Name * Name First Name First Name Last Name Last Name Email * Age (Years) * Payment Payment Payment Payment Month 123456789101112 Payment Year 20252026202720282029203020312032203320342035 Payment Please tell us about your daily routine, your work, responsibilities… * Category * Find solution for a problem I am facingHelp Understanding my situationI need someone to talk toHealing and Recovery Title of Challenge * Description of Challenge * What do you expect from the meeting? * Do you have any illness? If you have enrolled in consultation sesions before, please tell us more Do you have any questions or concerns? True / False I want to help myself I am asking for guidance I know that it is painful, I am ready to fell the fear and go for it Check list I am solely responsible for helping myself I know that facing a challenge reuires strength and willpower I seek guidance and support, but the change and the work depend entirely on me Note You will be contacted by email within 24 hours to schedule your session. Until then….take a deep breath, stay present. Stillness knows the way Submit If you are human, leave this field blank.
