Eligibility Form - C0vid V@x Healing Question Title * 1. What is your first & last name? Question Title * 2. What is your email (so we can contact you)? Question Title * 3. Name of the person you would like to book a healing for (if it's someone else) Question Title * 4. How open minded are you (or the person you're booking for) regarding spiritual concepts? Not very open minded Moderately open minded Very open minded Question Title * 5. How spiritually awake are you (or the person you are booking for)? Not spiritually awake Starting to awaken spiritually Very spiritually awake Question Title * 6. Were you (or the person you are booking for) coerced into getting the c0v|d j@b or did you/they willingly go out to get it? Coerced into getting the j@b Willingly took the jab Question Title * 7. How is your (or person you're booking for) mental state after getting the j@b? Feels bad about getting the j@b Nothing noticeable in their mental state Feels happy about getting the j@b Question Title * 8. Do you (or this person) feel like you/they have made a contribution to society by getting the j@b? Yes - they feel like they are making a contribution by getting the j@b No - they felt forced to take it Question Title * 9. If eligible for this healing session, you would be doing a healing session via Zoom. If you're booking for someone else, would this person accept a 1:1 Zoom session? Yes No Question Title * 10. If you are booking for someone else, this person must know and accept that you are booking a 1:1 Zoom session for them (if eligible). Have you received permission from this person? Yes No Done