Unleash Your Mind, Unleash Your World

Thank you for filling out this form! By answering these questions you give Uma and The Lotus and The Light Metaphysical Center permission to add you to their email list and contact you to schedule a discovery call. 

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* 1. What is your name? (First and Last) 

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* 2. What is your email and phone number?

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* 3. What is going on in your life that made you reach out to me?

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* 4. Please list any medical or mental conditions you have been diagnosed with

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* 5. How is your life in terms of your purpose, love life, career, health, ability to be there for friends and family, etc.?

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* 6. What have you tried in the past in terms of therapy, healing modalities, spiritual training, personal development work, etc?

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* 7. If someone told me to spend a couple hours a week, for several weeks, taking specific actions that would help me transform my life, I would ...

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* 8. Tell me why you are ready for this power and transformation at this time and why you should receive one of the limited spots for this opportunity

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