Lisa M Pepe - Pre Wisdom Session Questionnaire

Confidential Pre-Wisdom Call Information

Please answer the questions below so that I may better serve you in your session. Your information will be kept private and will not be shared. Intuitive Wisdom sessions are designed to help you better understand how to tap into and use your inner guidance system. This questionnaire helps me to focus in on your particular needs and situations so please fill up the comment boxes with details. Be sure to check your e-mails for additional information regarding your scheduled session. Looking forward to our call! Thank you -- Lisa M Pepe

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* 1. Address

First and Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Which, if any, of my programs are you participating in?

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* 3. Do you have any medical conditions?

Anemia

Anorexia or Bulemia

Asthma

Blood Disorders

Cancer

Celiac Disease

Chronic Constipation

Chronic Fatigue Syndrome

Chronic Lung Problems

Diabetes

Headaches

Heart

Hepatitis

High Blood Pressure

High Cholesterol Triglycerides

Kidney Problems

Low Blood Sugar

Neurological Disorders

PMS or Hot Flashes

Seizures or Epilepsy

Shortness of Breath

Swollen Ankles

Thyroid Problems

Other Health Conditions (please specify)

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* 4. Why would you like to tap into your intuitive self?

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* 5. Have you ever meditated or used visual guidance techniques?

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* 6. What do you hope to achieve in our session together?

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* 7. What are your reservations about tapping into your intuitive wisdom?

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* 8. Have you ever experienced any of the following?

A strong knowing of something that was about to happen

A gut feeling you should or should not do something

Communications from those who have passed

A connection to a higher power or energy source

Healing or relief from the energetic modality called Reiki

Relaxation from any meditation of 5 or more minutes

Other energy or body work - Describe in comments

Feeling lighter and more in tune from eating a healthy diet

Confidence in yourself and empowered by your decisions

Relief from breath work or deep breathing exercises

Work surrounding belief systems and your abilities

Please comment on any of your above choices here.

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* 9. Please put additional comments and questions here.

By participating in any programs offered by LisaMPepe.com, you, the participant agree to do so at your own risk. It is advised that those in poor health or with a pre-existing condition do not participate in any activities or programs without seeking professional medical advice before beginning. Anyone who chooses to participate agrees that they do so knowingly and do voluntarily assume all risks associated with such participation. LisaMPepe.com or its programs do not guarantee that anyone will achieve the same or similar results and LisaMPepe.com and its affiliates shall not be held liable.

At www.LisaMPepe.com, the privacy of our visitors is of extreme importance to us. We may collect information when you choose to visit and participate in activities and programs offered by LisaMPepe.com. We require this information to understand your needs and provide you with better service; for internal record keeping; to improve products and services; to send promotional emails about new products, special offers or other information which we think you may find interesting using the email address which you have provided; to contact you for market research and to customize the website according to your interests. If you have any questions or concerns, please email lisa@lisampepe.com. Please visit our website (www.lisampepe.com) for additional information about our programs and offers.