Intake – Part I (Basic Experiences) Name(required) Email(required) Phone Physical Address 1. When did this start? 2. Was there any unusual things that took place (or you did) when this bondage started? 3. If this started when you were a child: Do you have ancestors who have suffered from a similar kind of experience? 4. What kind of experiences are you facing? (Fears, depression, voices in your mind, mental illness, physical illness, mental torment, spiritual torment, etc.. Please be as detailed as possible.) 5. What are all the things that have impacted your life? (Parent's death, trauma, a certain situation that changed your life, anything that 'changed' you.) Submit Δ Share this:TwitterFacebookPinterestRedditTumblrLinkedInWhatsAppEmailLike this:Like Loading...
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