New Client Information Name * First Name Last Name Email * Age * Gender * Male Female State Country * Have you had sessions in any of the following fields before: Life Coaching, Counseling, Therapy, Psychiatry, Inner Healing, SOZO? * If you have, how regularly did it play a part in your life? * Please tell me about your experience. Was it helpful? If so, what breakthroughs did you receive? Was it a positive or negative experience and why? * Are you aware of what would be helpful to work through in your session with Kathy? * Please check any of the major emotions you are wanting to overcome * Fear Anxiety Anger Rage Hatred Self Hatred Lonliness Depression Sadness Hopelessness Rejection Unforgiveness Doubt Abandonment Shame Guilt Condemnation Emotional Pain Other If you selected 'other in the question above, please use the box to describe. Please check any of the major life experiences that you are wanting to discuss * Marriage Romantic Relationships Friendships Job Future Aspirations Spiritual Beliefs Inspiration Current Trauma Childhood Trauma Abuse Death of a loved one Rape Molestation Addiction Sexual Problems Other If you selected 'other in the question above, please use the box to describe. Thank you!
