Healing Consultation Intake Form - Siquijor Healers

Siquijor Healers Life Coaching Services

Healing Consultation Booking Form


What is Included in a Healing Consultation?

During the Healing Consultation, I will listen to your situation to better understand your needs and provide personalized guidance.

The consultation may include:

✓ Personalized conversation about your situation

✓ Practical and spiritual guidance

✓ Personalized advice and next steps

✓ Meditation session (if applicable)

✓ Healing Water (if applicable)

✓ Recommendations based on your unique situation

Not everyone requires the same method of guidance. Any recommendations will be based solely on your Healing Consultation.

Before You Begin

Please fill out the form below honestly and completely. The information you provide will help me better understand your situation before our consultation.

All information you share will remain private and confidential.

SECTION 1

Personal Information


SECTION 2

About Your Situation


SECTION 3

Pictures


SECTION 4

Payment


Healing Consultation Fee

₱1,000

GCASH:

  • John Eric V. Roxas
  • 09552954495

Metrobank:

  • John Eric V. Roxas
  • 9973800269416

Please make sure the screenshot or image of your payment confirmation is clear. Thank you.

SECTION 5

Schedule


SECTION 6

Confirmation


Note: This Healing Consultation Session is for your personalized guidance on the personal, emotional, practical, and spiritual aspects of your situation. It is not a substitute for medical diagnosis, medication, or professional medical care.

Thank you very much for your trust. I will review the information you submitted and contact you to confirm your Healing Consultation.