Intake form

Name *

Email address *

What services are you interested in?

Please select at least one option.

Feng Shui Consultation

Reiki Healing

Crystal Healing

All of the above

What is your preferred appointment date?

What is your preferred appointment time?

What is your primary goal for this consultation?

Have you previously experienced any of these services?

If yes, please describe your experience.

Do you have any specific areas of your home or office you would like us to focus on?

Are there any health conditions or concerns we should be aware of?

Which service or services are you interested in?

Please select at least one option.

Feng shui consultation

Reiki healing

Crystal healing therapy

Energy clearing

Intuitive guidance

Meditation and mindfulness coaching

Additional questions or comments

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