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About
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Healing Institute
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Application form Akashic blossom coaching
Akashic Blossom Coaching
First and last name
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E-mail address
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Date of birth
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Time and place of birth
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Why did you choose me to work with?
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What situation are you in now and what do you think you need?
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What do you want to achieve in: 3 months, 6 months, 1 year?
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What do you find most challenging?
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How motivated are you to change?
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To what extent are you able to commit?
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Are you ready to invest in your development now?
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YES
NO
Have you used other forms of help such as coaching, psychotherapy, energy work, Hellinger settings?
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YES
NO
If so, which ones? When?
Do you now use other forms of assistance?
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Why is now the best time for Akashic Blossom Coaching?
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Are you ready to take full responsibility for yourself and your process?
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The administrator of your personal data is Paulina Kulikowska. Your personal data will be processed for the purpose of processing your order or service and marketing communication by e-mail.
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