Request a Free 5-Min. QHHT Consultation

WA State Unified Business ID: 604 131 489

Everett, WA USA (206) 574-8844

Client In-Take Form

Merkaba Chakras QHHT

Client In-Take Form

Practitioner: Von Galt, (206) 574-8844

Eslcomputertraining@gmail.com

MerkabaChakras.com

 

 

Name: ________________________________________________________

Phone Number: _________________          Email: __________________          

Date of Birth: _________________              Age: ___________                                        

 

DISCLAIMER: The QHHT practitioner is not a healer. The practitioner can only facilitate the QHHT regression. QHHT is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The Client In-Take form is intended to prepare for QHHT. However, its insightful when completed honestly. QHHT allows a client to communicate with the Over Soul to garner a deeper understanding about their soul’s growth.

 

QUESTIONNAIRE:

There are three parts to the session.

 

  1. Interview and go over your questions you have for the Over-Soul. I also use a dowsing rod to measure the health of my client's chakras before a session. (15 mins)
  2. The QHHT Regression. (3 hrs)
  3. Recap interview and an updated energy dowsing. (15 mins)

*Soul Retrieval Script (if needed)

 

Below are the guidelines for common questions you want to have ready for your QHHT session.

 

RELATIONSHIPS/EMOTIONAL PAIN

List your soul group:

Parents:

 

Spouse(s):

 

Children:

 

Sibling(s):

 

Significant Friend(s):

 

Yourself:

 

Others:

 

Briefly describe your childhood in 5 sentences or less.

 

When you look at a picture of the people in your soul group…

            Do you feel any ANGER with any of these people?

                        Who?

                        Details?

 

            Do you feel any GRIEF with any of these people?

                        Who?

                        Details?

 

            Do you feel any WORRY with any of these people?

                        Who?

                        Details?

 

            Do you feel any STRESS with any of these people?

                        Who?

                        Details?

 

            Do you feel any FEAR with any of these people?

                        Who?

                        Details?

 

 

Why do you think you picked the parents that you have?

 

 

What vows (i.e. vow of poverty, celibacy, obedience, etc.) or Soul Contracts (between specific persons) do you want to explore?

If you died now, do you have any regrets?

 

Do you think you are enough?

 

 

PHYSICAL PAIN

If you have a pain, when did it start? What happened in your life at this time? Was there a person that causes negativity in you that entered your life at this time?

 

List any illnesses:

 

List any recurring injuries:

 

What are your symptoms?

 

What parts of the body are affected?

 

Do you have any physical pains that you avoid addressing that may have moved into your organs?

 

List any recurring issues in your relationships?

 

List any recurring issues in your career choices?

 

List the #1 recurring theme (positive/negative) or issue you deal with?

 

List a couple recurring secondary themes (positive/negative) or issues you deal with?

1.

2.

3.


 

CONVERSATION W/OVER SOUL

Below are a set of questions asked of the Over Soul in every QHHT.

 

What lessons can I learn from my parents whom I choose to be born through? Why did I choose them?

What lessons can I learn through the recurring themes in my life?

What lessons can I take with me from my regressions?

What is my purpose?

What advice can my Over Soul give me to have peaceful relationships and live a balanced lifestyle?

 

List any questions about your life journey and personal requests for the Over Soul to please remove such as quit smoking, exercise and eat better, remove the migraine headaches, pain in your joints, etc.

 

Your list of questions for the Over Soul:

1.

2.

3.

4.

5.

 

 

MUST DO BEFORE THE APPOINTMENT

Please review these pages within the Merkaba Chakras website:

 

https://merkabachakras.com/pages/qhht

 

https://merkabachakras.com/pages/chakras-auras

 

https://merkabachakras.com/pages/life-planning-karma-reincarnation

 

Circle the areas of the body you want to address where pain exists. Please make notations in the empty space below to explain the issue further.

In_Take_Form_Body_Diagram

Notes: