Client In-Take Form (6th Senses)
Information
Name: __________________________
Phone Number: _________________
Email: __________________________
Date of Birth: ____________________
Age: ____________________________
DISCLAIMER: The concepts discussed are exploratory. It is not intended to be a substitute for professional medical or legal advice. Everything is confidential.
SESSION INTENTIONS: What are your intentions/goals for this session?
QUESTIONAIRE: Please list your 6th sense(s) & challenges:
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SELF REFLECTION: Do you think you’re enough?
SOUL GROUP RELATIONSHIPS: Do you feel any anger, worry, stress, grief, or fear for any of these people?
Dad:
Grandparents (Dad’s Side):
Mom:
Grandparents (Mom’s Side):
Spouse(s)/Companion(s):
Children:
Sibling(s):
Significant Friends/Others:
CAREER & HOBBIE$: What is the outcome you want to experience in your career?
SOCIETY & CULTURE: List your issues with your society or culture?
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3.
PHYSICAL & ENERGY BODY: If you have a pain, when did it start?
Was there a person or event that entered your life at this time?
Do you have any illnesses OR recurring injuries?
What are your symptoms?
Circle the areas where pain exists. Make notations in the empty space below to explain further.
Notes:
EASTERN ENERGY CHAKRA BALANCING: Have someone point a dowsing rod at each chakra. If it moves slightly or none, then it’s balanced. If it swings heavily, then it’s out of balance. Refer to this page for details to each imbalanced chakra. Your merkaba (aura field) tells you what needs to be addressed to re-eastablish balance. https://merkabachakras.com/pages/chakras-auras
Prepare for Your Appt. with Gamma Exercises:
A) Be grateful by listing things you are grateful for. Gratitude releases Gamma waves.
B) Listen to music with binaural beats in Gamma waves and focus on the end result. Don't focus on the details, that's God's job. Youtube has a huge free library of Gamma wave music to listen to.
1x1 6th-Sense Consultation Cost:
At the 6th senses consultation, it is a video using Zoom or Skype. This way, I can see your abilities if you need to show me so I can assess them before making recommendations. The consultation is a 1-hour session. We can extend it to a 2-hour appointment if needed. My philosophy is to keep it simple and not overwhelm you with homework. So, I prefer to work on the initial 6th senses to anchor those in and adapt before we go further into next-level suggestions. Often, my 6th sense clients schedule recurring quarterly appointments as they continue to amplify their spiritual abilities responsibly. In Buddhism, the lamas and aides would help people learn to work with their amplified or awakened 6th senses, which is a process of spiritual awakening and ascension within onself towards Buddhahood. Now, since this is happening worldwide to people all over the world due to the Earth raising her frequency further into the 5th dimension, everyone living on her is also getting raised up in frequency whether they're ready or not. It's like humanity is having a growth spurt, and needs to learn new ways of living with their new bodies.
- $90 for a 1-hour session over the phone or Skype/Zoom (9.8% Sales Tax Included).
- $180 for a 2-hour session over the phone or Skype/Zoom (9.8% Sales Tax Included).
Accepted Payments:
All major credit and debit cards, Bitcoin, Venmo and PayPal are accepted.
Just submit a contact us form when you're ready to schedule a 1x1 consultation call with author, Von Galt. Please write in the form WHAT TIME ZONE YOU'RE IN so she is aware of it. Thank you for your choosing me to assist you in leveling up your 6th senses.
