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the Clearing Center
Begin
our team
personal sessions
classes & events
retreats
connect
Login Account
0
0
Begin
our team
personal sessions
classes & events
retreats
connect
Login Account
Name *
What do you know about your birth?
Have you had any diseases, injuries or surgeries?
Diagnosed with a psychological condition? Do you have anxiety/depression? Are you on medication?
Do you generally express emotions freely?
Do you have any spiritual practices? Do you meditate? How connected do you feel to Spirit?
To what extent do the following issues affect you today?
Addictions
Smoking, Drinking, Food, Drugs
Physical Symptoms
Tiredness, Headaches, Stomach Issues, Pain, Insomnia
Emotional Well-being
Anxiety, Anger, Isolation, Depression, Reactive
How would you evaluate your relationship with Self?
Relationship with Family?
Relationship with Friends/Coworkers?
On a scale of 1-10 how connected to Spirit are you? (1 being least and 10 being most)

Thank you! We look forward to being with you soon.

 

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