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Home
About Us
Services
Guided Meditations with Vocal Sounds
Personalized Energy Healing Sessions
Expansion Seminars & Workshops
Conscious Transformation Retreats
Consciousness Calibration
Quantum Mapping – Blue Print
Blog
Contact Us
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Quantum Mapping – Blue Print
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Aura Harmonization - Has Attended Sessions Before
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Aura Harmonization - First Session
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Name
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Agenda una cita
How would you describe your life right now? (Select all that apply)
Calm
Busy
Stressful
In transition
Uncertain
Emotionally intense
Stable but unfulfilled
Expanding / growing
Are you currently experiencing any challenges, changes, or situations? (Select all that apply)
Career or work changes
Relationship challenges
Grief or loss
Relocation or lifestyle change
Health-related concerns (non-medical)
Emotional burnout or exhaustion
Financial stress
Identity or purpose questioning
Spiritual awakening or shift
Major decision-making period
None at this time
How does your body feel most days? (Select all that apply)
Energized
Tired
Heavy
Tense
Balanced
Restless
Sensitive
Variable / changes often
Do you experience any recurring physical discomfort or low energy? (Select all that apply)
No
Yes – Headaches or migraines
Yes – Neck/shoulders/back tension
Yes – Digestive discomfort
Yes – Low energy or fatigue
Yes – Sleep-related tiredness
Yes – Hormonal or cycle-related discomfort
Yes – Chest tightness or shallow breathing
Yes – General body aches
Yes – Sensitivity to noise, light, or environments
Do you have any medical or psychological conditions that you feel we should be aware of for safety or comfort during this work? (Optional – please describe briefly. No diagnosis or details required.)
How would you describe your sleep? (Select all that apply)
Restful
Light
Interrupted
Difficult to fall asleep
Waking too early
Variable / inconsistent
Restorative only sometimes
What emotions do you feel most often lately? (Select all that apply)
Calm
Anxiety
Sadness
Overwhelm
Irritability
Numbness
Joy
Frustration
Fear
Hopefulness
Emotional ups and downsEmotional ups and downs
Do you feel emotionally supported in your life right now?
Yes
Somewhat
No
Unsure
Do you experience mental overload, worry, or repetitive thoughts?
Often
Sometimes
Rarely
Almost never
Do you feel connected to yourself and your inner guidance?
Yes
Sometimes
No
Not sure
Have you worked before with any of the following? (Select all that apply)
Meditation
Sound healing
Breathwork
Energy work (Reiki, etc.)
Spiritual guidance or coaching
Yoga or somatic practices
Plant medicine or ceremonial work
None of the above
Do you currently feel: (Select all that apply)
Blocked
Disconnected
Out of balance
Drained
Open and receptive
Curious but unsure
Grounded
Do you feel you are walking the right path in your life right now?
Yes
Unsure
No
I feel a change is coming
Are there repeating patterns or situations you don’t fully understand? (Optional – please describe briefly)
What inspired you to reach out to us at this time?
What kind of support are you seeking? (Select all that apply)
Emotional balance
Stress relief
Nervous system calming
Energetic clearing
Clarity & direction
Spiritual connection
Healing support
Grounding and embodiment
Integration after a life change
If you could feel one thing differently after working with us, what would it be?
Preferred days for sessions (Select all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred time of day (Select all that apply)
Morning
Afternoon
Evening
Flexible
How frequently do you feel would best support your intention?
One session
Weekly
Bi-weekly
Monthly
Unsure / open to guidance
Timeline for beginning and duration (Select all that apply)
As soon as possible
Within 1–2 weeks
Within 1 month
Ongoing / open-ended
Agreement
I understand that this work is energetic and consciousness-based, and does not replace medical or psychological care. I participate willingly and understand that results vary according to each individual.
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