* 1. What country do you currently live in? ( You can add your city in the other section, so when I am visiting your country we can have a meetup)

* 2. 2. What is your age?

* 3. 6. How Would You Describe Yourself ( you can choose more than one answer and feel free to be more expansive in the other box)

* 4. 4. Do you ever ask yourself… ( tick all that apply and add anything else that you might ask yourself.)

* 5. Are you feeling blocked in any way or are there some challenges stopping you from living your heart's desire?

* 6. f there was help to solve this challenge what is your desired outcome?

* 7. Anything else you want to share with me? ( all confidential )

* 8. Thank you. You are very special.  I really appreciate your taking the time to fill this in. To get my new  Heart Whisper Meditation, put your name and email below.

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