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Client Feedback Form Self Paced

Client Information

Practitioner Information


We appreciate answers to this form in English.


The invocation part of a session relates to the opening – the sacred space set, the calling in of supportive energies, chanting mantra etc.


The conversation part of a session allows your practitioner to get a deeper understanding of what is present for you, ask questions, understand the challenges you are facing, and allows you space to feel seen and heard in your experience. It also allows the practitioner to explain the session process.


The activation part of a session takes you out of the mind (conversation) and into the body, encouraging you to feel, express and release undischarged energy and emotions. For Zoom sessions, the bodywork question is less relevant, but you can reflect on the energetic guidance and holding the practitioner provided.


The integration part of the session allows you time to digest the session, clarify new beliefs and insights and receive homework suggestions from your practitioner

Please rate how you felt about the following during the session:

Not safe
Completely safe
Strong sense of judgement
Strong sense of non-judgement
Felt very unheard
Felt deeply heard

Please rate how you felt about the following during the session:

Very unclear
Very clear
Not effective
Very effective
No time at all
Way too much time
Didn’t feel relevant, unlikely to use
Exactly what i needed

“Thank you for submitting this form. Your information has been received and your Practitioner will follow up with you directly, if necessary.”