1-on-1

Bespoke

Mind-Body Healing Transformation

for Psychosomatic Pain

Complete the form below to request a complimentary consultation.

Please answer ALL questions to the best of your ability so I may accurately assess whether I can help with your problem. Consultations will not be offered for incomplete requests.

If I can help, I'll offer to meet for a 30 to 60 minute complimentary consultation. We'll talk about the problem in more detail and how we could possibly work together to accelerate your healing and get you feeling better.

Meetings are carried out in English as online video calls via Google Meet in the afternoon hours of Eastern Standard Time (EST).

1. What is your first name?

2. What is your last name?

3. What is your email? Please double check for typos.

4. What is your current country of residence?

5. Where do you feel pain in your body?

6. How would you describe the way it feels?

7. How severe is it on a scale of 1 (barely noticeable) to 10 (excruciating)?

8. When did the pain start? What is the suspected cause?

9. What helps it feel better?

10. What makes it feel worse?

11. What medical assessments, testing, and imaging have been done? What were each of their findings?

12. What treatments (both medical and alternative) have you tried? What were each of their results?

13. What professional advice (both medical and alternative) have you received about what to do for the pain?

14. Is there anything else you want me to know?

15. How did you find me (medical referral, personal referral, Google, etc.)?

Need to get in touch? Email transformationalcoach.online@gmail.com