First Name
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Email
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How are you feeling emotionally right now?
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Uncertain and insecure
Creatively blocked
Lacking confidence and direction
Emotionally closed off or overwhelmed
Difficulty expressing yourself
Intuitive but confused
Disconnected spiritually
Which of the following physical symptoms are you experiencing?
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Fatigue or lower body pain
Reproductive or urinary issues
Digestive problems or stomach issues
Heart-related conditions or upper back pain
Sore throat or voice problems
Headaches or vision problems
Sleep disorders or mental disturbances
What area of your life feels most out of balance?
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Security and stability
Creativity and pleasure
Motivation and personal power
Love and relationships
Communication and truth
Intuition and insight
Spirituality and connection
What kind of activities resonate with you the most?
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Grounding activities like gardening or walking barefoot
Artistic activities like painting or dancing
Physical exercise or personal development
Compassionate activities like volunteering
Speaking or writing
Meditation or mindfulness practices
Spiritual practices like yoga or prayer