Mentoring Intake Form

Are you experiencing any flu symptoms?
All the information you submit on this intake will be kept confidential. Upon submitting this form, all answers in the boxes will be sent directly to Karen Hale's personal email, This information will only be seen by Karen Hale. You can reserve the right to not disclose your personal history. It is solely up to you which questions you choose to answer. However, all fields are required to have an answer. If you choose to not answer please type, "No Answer" in the field.  

Personal History Questions

If you could have anything your heart desired and everything was possible, what would your dream life look like? Use your feeling and emotional body to contact clear, descriptive adjectives that describe your dreams. This will also invoke the subconscious minds creative capacity to expand beyond your currently reality.
​There are a total of

(216) 369-9144

5340 Hamilton Ave #205, Cleveland, OH 44114, USA

©2020 by Sistrum Inc.