Intake form

Help us serve you better

Name *

Email address *

What type of healing are you interested in?

Please select at least one option.

Coaching

Energy Healing

Sound Healing

Guided Meditation

Holistic Therapy

How did you hear about us?

What is your primary goal for seeking healing?

Do you have any specific concerns or issues you would like to address?

Preferred method of contact

Are you open to in-person sessions?

What is your preferred session length?

Which service or services are you interested in?

Please select at least one option.

Additional questions or comments

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Seromi Healing