Application form Akashic blossom coaching

First and last name

E-mail address

Date of birth

Time and place of birth

Why did you choose me to work with?

What situation are you in now and what do you think you need?

What do you want to achieve in: 3 months, 6 months, 1 year?

What do you find most challenging?

How motivated are you to change?

To what extent are you able to commit?

Are you ready to invest in your development now?

YES

NO

Have you used other forms of help such as coaching, psychotherapy, energy work, Hellinger settings?

YES

NO

If so, which ones? When?

Do you now use other forms of assistance?

Why is now the best time for Akashic Blossom Coaching?

Are you ready to take full responsibility for yourself and your process?

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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