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This questionnaire allows me to get to know you better.  Husband should fill out his own form, and wife should fill out a separate form of her own.


This questionnaire is designed to capture an initial ‘state-of-being’ by self evaluation and personal reflection. Please be completely honest with your responses knowing that this is not to create judgement or negative feelings of self, but to define where you currently are in relation to your desires and beliefs. The more insight I have into your present thoughts, feelings, and beliefs, the more direction and support I can provide.  Write as much as you can in your response. Do not leave an emotion, thought or belief unidentified. This document is a statement of Truth and Intention.  Our intentions carry a very powerful frequency (energy) that affects our daily living. Be thoughtful and thorough for yourself. 


 The more specific you are with your answers, the better I will be able to help you during our work together. 

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