0438 520 219 | 3/373 Glen Osmond Road, Glen Osmond, SA 5064 myintrinsicmind@gmail.com

Personal Questionnaire

Thank you for filling out the Questionnaire below

    How long have you had this problem? What have you done about it?
    Did the things that your previously did, work?*

    How intense are your feelings which are associated with the problem (on a scale from 1-10 with 10 being extremely intense)?*

    Can you get in touch with the emotions as you type and think about this?*

    Do you ever feel positive/negative emotions?*

    Feel free to elaborate on the negative and positive emotions*

    Have you heard that you have an Unconscious Mind?*

    Why do you want to let go of the problem?*

    Are you at Cause of your creation of this problem?*
    (Leisa will explain this further)

    How will you know that the problem has disappeared at the end of our session(s)? What will you see, hear, feel, say to yourself when the problem has disappeared?*

    What will happen when you get your outcome? What will you feel? What will you feel? How will your family (business associates) react o you letting go of your problem?*

    We may give you some Tasking before we see you. You must do those tasks or we cannot see you. Do you understand? Is that OK?*

    3/373 Glen Osmond Road,
    Glen Osmond, SA 5064

     

    Jen 0406 939 090
    Leisa 0438 520 219

    myintrinsicmind@gmail.com

    Skype: intrinsic_mind