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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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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)

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

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

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

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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