New Client Application

Please fill out the form below to see if we are a fit to work together and inquire about appointment availability. 

Name *
Is this your first hypnosis session? *
Have you received Reiki before? *
How is your current life?
Survey *
Please indicate your feelings about the below statements.
I am committed to my success and wellbeing.
I believe in past lives.
Meditation is important.
I consider myself an empath.
You have read and agree to the terms. *
You can find them here: