Align/Attune Intake Form It is YOU that actually creates the possibility of what you want and this is where you do so. What you do when you answer the following questions is imprint your desire onto the vast field of potential, so make this count! Be clear on what you want and express gratitude as if you already have it. A record is imprinted in the ethers when you do so and in your session, I access this record, clear energy that blocks you from it, while channeling to you elements from nature that raise your vibration to match your desire. Try not to even mention what you DON'T want. Only focus on what your life would be like if you weren't experiencing what you don't want. In other words, if you were past the problem and experiencing what you DO want. Keep in mind, BIG requests (like winning the lottery) mean BIG changes in your energy and BIG releases are necessary to bring you to the vibration that will create your desire. If you're ready for this, that's great! If not, focus on the next step in your journey... one that you're ready for and willing to release all that gets in the way of you having it. Spirit will show me what is possible now or in the near future given the release that will take place and what the physical body can handle. This Form cannot be submitted until the missing fields (labelled below in red) have been filled in Align/Attune Session Questionnaire Please note that all fields followed by an asterisk must be filled in. First Name* Last Name* E-Mail Address* Street Address City* State/Prov* Zip/Postal Code Country*CountryUnited StatesCanada----------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribadiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoFederated States of MicronesiaMoldovaMonacoMongoliaMontserratMoroccoMontenegroMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaS. Georgia and S. Sandwich Isls.Saint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamUS Virgin IslandsWallis and Futuna IslandsWestern SaharaYemenYugoslavia (former)ZaireZambiaZimbabwe Home Phone Birth Date (MM/DD/YYYY)* Gender* Male Female Problem, if any.If there is a 'problem' you wish to transform, please describe it in the most accepting way you know how… as if this has been an experience that would teach you something or be of benefit in some way… and now you’re simply ready for a new experience. Briefly describe or label what you want to manifest. This label acts as a placeholder for the energy you put into it in your answers that follow.* What does your desire look like?* (Important: State as if you're telling a friend what you've received, or what you've been doing, etc) What will you do when you have your desire?* (Important: State as if you're already doing it) What does it feel like to have your desire?* (Important: State as if you're experiencing your desire right now) Your desire is in the process of becoming physical, how can you express your gratitude as if you already have it?* (Important: State as if you're telling your story of HOW your desire manifested.) Please enter the word that you see below.