Please take some time to fill out the chakra questionnaire below prior to your first session. This form is designed to help me learn more about your energy centers, and will remain confidential. With regards to the questionnaire, most questions are two fold. Select only one answer for each question. Remember that this questionnaire is meant to help me to understand more about you so I may customize your nutritional healing and create harmony in your physical and energetic body. Don’t rush through the questions, rather try to reflect on each question before answering. Honestly answer each question to be true at least 90% of the time.