The Immersion Intention Intake

All information shared here is private and honored with confidentiality.

Name

First Name

Last Name

Email

Best phone number to reach you

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Subject

How did you find The Immersion?

What about The Immersion interests you?

Have you received any of the healing modalities The Immersion offers? If so, which ones and what was your experience with them?

What are your intentions for committing to you through The Immersion?

Please share a few dates and times that work for you for a 15 minute consultation with me.

Any questions?