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Cabalistic Healing
PRIVATE AND CONFIDENTIAL CLIENT INFORMATION
Today's date:______/_________/_________/
Name____________________________________________________________________
Address____________________________________________________City________________State_____
Your Birth Date_____________________
Your City of Birth _______________________________State_________Zip___________-___________
Your Time of Birth______________AM__________PM___________(Circle one)
Phone ( ______ )________________________
Occupation____________________________ How Long?__________________________
Are you over the age of 18___________Yes___________No - Circle one
Married______________Single__________Yes___________No - Circle one
IMPORTANT NOTE
The success of my Cabalistic Healing session is largely based upon your true desire to heal your body your mind and your spirit. Your confidence and trust in your therapist is greatly appreciated but I need you to answer honestly all the questions in this form. Doing so will drastically help me to remove any deep inserted phobias, free your spirit from fears and illnesses and release your God given healing power you were born to acknowledge and use to live a more productive and happy life.
IMMEDIATE OBJECTIVES
# BY ORDER OF IMPORTANCE ~ WHAT IS MOST MISSING IN YOUR LIFE RIGHT NOW?
TOTAL PEACE OF MIND
REAL HAPPINESS
MORE SELF ESTEEM
GREAT PHYSICAL HEALTH
GREAT SPIRITUAL HEALTH
SPIRITUAL REGENERATION
TRUE LOVE RELATIONSHIP
SATISFYING SEX LIFE
FINANCIAL SECURITY
A GREAT CAREER
OTHER (explain)
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CHEMICAL DEPENDENCY
Before working on your mind and your etheric body and for your safety; (Circle one)
| 1. Do you suffer any mental or physical health problems I should be aware of? |
__yes___no |
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2. Any history of: Heart trouble? - Epilepsy - Lung Disorder? Mental illness? |
___no___If yes circle |
| 3. Are you currently taking prescriptive medications? |
__yes___no |
| 4. Recreational Drug use? |
__yes___no |
| 5. Do you drink alcohol? |
__yes___no |
| 6. Alcohol consumed weekly: ___Never |
____ or number of drinks per week |
SPIRITUAL EXPERIENCES
Check and tell me if you have worked with: (Circle one)
| 1. A Psychologist, Psychiatrist, Hypnotherapist or Psychotherapist? |
___Yes___No |
| 2. Was the experience positive? |
___Yes___No |
| 3. Where you ever part of a cult or religious group? |
___Yes___No |
| 4. Were you raised religiously? |
___Yes___No |
| 5. Did your parents teach you fears such as going to hell? |
___Yes___No |
| 6. Do you or have you seen a lot of psychics? |
___Yes___No |
| 7. Did you ever have a bad experience with a psychic? |
___Yes___No |
| 8. Are you afraid of the dark or of being alone? |
___Yes___No |
| 9. Have you ever experienced a good spiritual event? |
___Yes___No |
| 10. Have you ever experienced a bad spiritual event? |
___Yes___No |
PARENTS RELATIONSHIPS – UPBRINGING (circle one)
You MUST tell me all your deepest fears so I can remove the phobia from your subconscious.
Psychic accidents are real and common when dealing with unprofessionals.
| Do you have a good relationship with your Mother? |
|
___Yes___No |
| What do you like or dislike most about your Mother? |
|
___Tell me more during our meeting |
| Do you have a good relationship with your Father? |
|
___Yes___No |
| What do you like or dislike most about your Father? |
|
___Tell me more during our meeting |
| Have you kept a secret because of a friend or a family member? |
|
___Yes___No |
| What do you like or dislike most about this person? |
|
___Tell me more during our meeting |
PHOBIAS – SEX ABUSE - GUILT FEELINGS
You must answer those difficult questions to the best of your knowledge as to help me to remove any subconscious poisoning that trigger guilt, suffering, hidden pain fears and deep seated phobias.
(Circle one)
| Have you ever been molested by a family member, a priest or friend? |
|
___Yes___No |
| Do you often carry heavy guilt with you? |
|
___Yes___No |
| Is your biggest guilt feeling due to holding a secret? |
|
___Yes___No |
| Is your biggest guilt feeling of a sexual nature? |
|
___Yes___No |
| Can you talk about sex openly and without shame? |
|
___Yes___No |
| If no, will you tell me why you would you not talk openly about sex? |
|
___Yes___No |
| How old were you when the worst experience in your life took place? |
|
___yrs old |
Number your answers from 1 to 10 in order of strength - Do you think or feel this living guilt/phobia affects your;
| Judgment: |
( ) |
| Life style: |
( ) |
| Sexual Life: |
( ) |
| Happiness: |
( ) |
| Relationships: |
( ) |
| Peace of mind: |
( ) |
| Perception of the world: |
( ) |
| Your behavior with men or women: |
( ) |
| Your mental and physical health: |
( ) |
| Your self esteem: |
( ) |
SLEEPING DISORDERS - (Circle one)
| Do you sleep well? |
|
___Yes___No |
| Do you suffer many nightmares? |
|
___Yes___No |
| Did you or do you still use sleeping pills? |
|
___Yes___No |
| Do you often wake up feeling low and depressed? |
|
___Yes___No |
| Do you wake up and feel like falling down? |
|
___Yes___No |
| What is the nature of your worst dream? |
|
___Tell me more during our meeting |
| What is the nature of your best dream? |
|
___Tell me more during our meeting |
| Is sex often a part of your dream state? |
|
___Yes___No___Sometimes Are those dreams good or bad? ___Good___Bad |
| Are you afraid of water? |
|
___Yes___No |
| Are you afraid of fire? |
|
___Yes___No |
| Are you afraid of some people? |
|
___Yes___No |
| Are you afraid of animals? |
|
___Yes___No |
| Are you allergic to animals? |
|
___Yes___No |
| What is your favorite animal (s) and explain to me why? |
|
_________tell me more during our meeting |
| If anything or anyone makes upsets you, what would it be? |
|
_________tell me more during our meeting |
| What type of food you like or dislike? Why? |
|
_________tell me more during our meeting |
| What color do like or dislike? Why? |
|
_________tell me more during our meeting |
| Do you like flowers and if so, any type in particular? |
|
___Yes___No______________ |
| What is your favorite smell? |
|
__________ |
INTERACTION
Your PRIVACY WILL BE TOTALLY RESPECTED AND ASSURED
PHYSICAL OR MENTAL PREDICAMENTS CAUSE BLOCKAGES AND CHEMICAL UNBALANCES (CIRCLE ONE)
(This part of the questionaire is for females only)
| What do you dislike most about a person? |
__Appearance__Attitude__Dress style__Smell__Voice__Bad Habits? |
Have you had side effects from medical prescriptions? |
___Yes___No |
| Are you menstruations regular? |
___Yes___No |
| Are you menstruations regular? |
___Yes___No |
| Do you bleed heavily? |
___Yes___No |
| Have you ever missed a menstrual cycle? |
___Yes___No |
| Are you sexually active? |
___Yes___No |
| Do you use contraceptives regularly? |
___Yes___No |
| If so how long? |
___Weeks___Months___Years |
| What brand? |
_________________________ |
| Over the counter brand? |
___Yes___No |
Did you check with your doctor before using that brand (for the "pill")? |
___Yes___No |
| Are you still using the same brand? |
___Yes___No |
| Are you using the pill now? |
___Yes___No |
Does the pill make you feel different when you do not take it? |
___Yes___No |
| Are you prone to Urinary infections? |
___Yes___No |
| Are you prone to abdominal pains? |
___Yes___No |
| Are you in a relationship? |
___Yes___No |
If no – how long has it been since your last relationship? |
___Weeks___Months___Years |
If yes; are you happy in your relationship? |
___Yes___No |
What is your biggest problem with this person? |
___Tell me more during our meeting |
Do you feel guilty about living that person? |
___Tell me more during our meeting |
If your relationship is detrimental to your mental health why do you stay? |
___Tell me more during our meeting |
Do you think it is a for financial
reasons or due to emotional insecurity? |
___Tell me more during our meeting |
What would it take for this
relationship to work in your favor? |
___Tell me more during our meeting |
Are you willing to work on this situation or you’d rather move on? |
___Tell me more during our meeting |
SEXOLOGY ~
HYPNOTHERAPY ~ CABALISTIC HEALING (Circle one)
ALL DESTRUCTIVE PHOBIAS ARE INDUCED DURING CHILDHOOD OR YOUR TEENS, OFTEN IN THE FORM OF MENTAL OR PHYSICAL ABUSE.
THESE DEEP ROOTED CONDITIONS WILL STOP YOU REACHING PEACE AND HAPPINESS.
Do you feel or believe you have been abused as a child? |
___Yes___No___don't know |
Did you ever suffer any form of abuse from a person? |
__Yes__No. If so, who? __husband ___boyfriend __father __mother __friend |
| Do you suffer panic attacks? |
___Yes___No |
Did you or do you feel like
giving up on your life or dreams? |
___Yes___No |
| Do you nurture fears of going crazy? |
___Yes___No |
Are you willing to make the NECESSARY changes to reach your goals? |
___Yes___No |
If so are you willing to explore Astropsychology as a form of healing? |
___Yes___No |
If so are you willing to explore Hypnotherapy as a form of healing? |
___Yes___No |
If so are you willing to explore Cabalistic healing as a form of healing? |
___Yes___No |
If so are you ready to explore any Hypnoptic, Tantric or Cabalistic techniques as forms of healing? |
___Yes___No |
Are you familiar with any of the healing methods mentioned above? |
___Yes___No___Some |
All methods of healing are safe and work on both the subconscious and physical planes. Once explained in detail you may chose any or all the methods I practice.
What do you really need to have in a lover?
(Number by order of preference)
| Sense of Humor - |
( ) |
| Intelligence - |
( ) |
| Education - |
( ) |
| Attitude - |
( ) |
| True love - |
( ) |
| Respect - |
( ) |
| Money - |
( ) |
| Position - |
( ) |
| Physical Appearance - |
( ) |
| Strong Sexual Drive - |
( ) |
| Romance - |
( ) |
| A sense of security - |
( ) |
What do you think needs to be changed about YOU to reach true love and happiness? (Number by order of preference)
| More self esteem - |
( ) |
| A better attitude - |
( ) |
| Understanding - |
( ) |
| Giving true love - |
( ) |
| More dedication - |
( ) |
| Make more money - |
( ) |
| Less emotional - |
( ) |
| Better appearance - |
( ) |
| More sexual drive - |
( ) |
| More romance - |
( ) |
| Less needy - |
( ) |
| More education - |
( ) |
| More trust - |
( ) |
| Are you a vegetarian? |
___yes___no |
| Do you like Sushi? |
___yes___no |
Are afraid of sexually transmitted diseases? |
___yes___no |
| Do you like Sushi? |
___yes___no |
Were you taught that sex is bad or taboo or dangerous by your parents? |
___yes___no |
Is having sex or making love the same thing to you? |
___yes___no |
Is imagination and variety in love making important to you? |
___yes___no |
Cabalistic and Tantric Healing
Repressed sexual energy is the leading cause of unsatisfying sexual performance and lead to a lack of self esteem, depression and serious frustration. The Cabalistic Healing technique acts as a valuable and safe tool to unlock and distribute the Kundalini corporeal life forces throughout the body, mind and spirit.
Will you trust Cabalistic Healing to improve your sexual and spiritual life? |
___Yes___No |
Would you trust yourself and your Doctor to release your Kundalini energy? |
___Yes___No |
IMPORTANT NOTE
Cabalistic Healing is a powerful highly effective and safe Healing Art Methodology
This rare healing practice deals with deep physical and spiritual cleansing and highly gratifying to the patient and can only be performed with your full consensus and the unconditional trust you place on the practitioner. Physical and spiritual chemistry including total trust between you and your healer is an important part to take in consideration. The goal is to slow down the physical body as to centralize and recharge the etheric body. Super charged crystals, precious stones, infra red lights, pendulums, gong and ultra sound table are used during the Cabalistic healing session.
Steps;
- Cleansing the body Mind and spirit using Cabalistic Cleansing. Crystal ball (black/white), alcohol and heated foot SPA therapy are used to cleanse your body.
- Connecting with your SPIRIT identity using Astropsychology. About one hour of Divine information pertaining to your relationship with the Universal Mind. The session is taped.
- Connecting with both your PHYSICAL (shell) and ETHERIC (soul) bodies Cabalistic Healing.
- Connecting with your Kundalini forces and your subconscious using Hypnotherapy if needed.
- Your Body Mind and Spirit must undergo a total cleansing before entering the healing room.
Explanation of Cabalistic healing methodology and benefit:
This old Cabalistic Cleansing methodology is used to remove all physical or spiritual blockages and boost both your self esteem and your immune system.
The goal is to use the Kundalini life force located in the lower chakra areas to accelerate the influx of prana opening the healing energy process.
If you have never been abused and enjoy a normal healthy life the Cabalistic Healing session will certainly offer you a very pleasurable and relaxing way to release your own tension.
I hereby agree and acknowledge that all these Cabalistic Healing, Hypnotherapy and Astropsychology techniques present safe & powerful methods to restore mental and physical balance. I am assured by Dr. Turi that I will remain completely conscious during any of the sessions. By signing this form I am fully informed of the safety of the procedures and usefulness of homeopathic medicine and its Healing purposes. Further, I am aware that this program is highly spiritual, very relaxing, pleasurable, not dangerous and non medicinal in nature. No prescriptions will apply and for any changes in my medications if needed, I will consult my regular health practitioner.
Signature_____________________________
Date___________________________________
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