Intake form

Help us serve you better

Name *

Email address *

What type of support are you seeking?

Please select at least one option.

Life Coaching

Psychedelic Facilitation

Qigong Instruction

Sound Healing

What is your preferred method of communication?

Have you participated in any coaching or wellness programs before?

If yes, please briefly describe your experience.

What are your primary goals or challenges you would like to address?

What is your preferred time zone?

Do you have any specific dates or times in mind for your sessions?

Additional questions or comments

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Pathwei LLC