Professional Paid - Elite EFT Practitioners - Transformation Program Intake Form

TRANSFORMATION PROGRAM - INTAKE FORM

Please fill in the form below so that your practitioner can focus on what you want during one to one sessions.

*mandatory field, please fill in.

First Name *
Last Name *

Date of Birth ( Please select the right format, eg 15-01-1976) *

E-mail to contact you *

Phone Number to contact you *

Current City for Time Zone *

Current Country *

Relationship Status *

Profession, for eg trainer, home maker *

Preferred Language for Sessions *

Other Languages for Sessions *

1. What are the areas you would like to explore during your transformation program? For example, problems you would like to solve or heal, any goals you desire or outcomes you want. *

2. What are the 3 most important changes you would like to make in your life? *

3. What prevents you from making these changes? *

4. Answer only if relevant: What have you done so far to solve the problem or reach the goal or outcome? What has worked and what has not worked?

5. How will you know you have made these changes? *

6.What are the priorities you would like to focus on during the Transformation program? (list top 3 in order) *

7. What are your expectations from your coach/practitioner ? *

8. On a scale of 1 to 10 how committed are you to achieving the results and changes you desire? (10 being fully committed, 1 being not at all) *

9. Any other information (for example information from medical professionals and healthcare specialists) *

10. EFT Practitioner you want to work with (read the instructions below): *

If you have a preference for the EFT Practitioner you want to work with, you can just type their name above. Here is the list of our EFT Practitioners. We cannot guarantee that they will be available, however we will do our best to get you connected or find you the best fit. You can also leave the above blank and let us match you up with the EFT Practitioners.

Submission of this form means that you have read, understood and agree to these guidelines and terms.

In summary you understand these sessions are:

• Therapy, coaching or healing with EFT, NLP, Coaching, Journey Work, Limitless Living, Hypnosis, & Inner Child work.

• Not medical/mental health diagnosis or treatment

• Private and confidential, with any records being kept in a secure place

• If you have any questions about your session or the above information, please contact us on [email protected].

Yes I understand *

We would love to connect:

+919920454749 (India), +919820974625 (What's App)

[email protected]

Full list of certification training and seminars.