PRIVATE PRACTICE INTAKE

Utterly Confidential

 
Name *
Name
Remote Contact Preference
What shall we Feng Shui? *
Do you own or rent? *
Does anyone else live with you, or share this space with you? *
Are you experiencing any health issues?
Have you renovated your space? *
Have you previously applied Feng Shui in this space? *
Do you have a storage unit, or keep any possessions offsite? *
for In person clients: