First Name

Last Name

Email Address

Trusted Friend's Mobile Number & Country Code

Why you need this session? Please provide 5 questions that you want to ask your Higher Self or Subsconscious during our session. Eg: Why am I stuck with my life? What is my life's purpose? Am I following my soul's purpose? I want to quit my job, how can I transition?

Have you had Past Life Regression before? Yes/No Have you had Past Life Regression before? Yes/NoYesNo

Safety and Technology Requirements: Safety and Technology Requirements: I confirm that the session is online and not face to face. I confirm that I have a strong internet connection and a built-in or external camera on my device for video calling (ideally laptop or desktop). I confirm that I have a decent microphone and headphones to communicate and hear the session clearly respectively. I confirm that I will be alone in a quiet, comfortable space where I can lie down or sit on a reclining chair during my session while still able to hear clearly using headphones and microphone. I confirm that my emergency contact is with me in the same property (not in the same room) during my session in case of technical issues, such as power cuts.

Session Length: Session Length: I am aware that the session can take at least 3-4 hours.

Age and Diagnoses: Age and Diagnoses: I can confirm that I am over 18 years old and I am NOT diagnose with Alzheimer or Schizophrenia.

Terms and Conditions and Privacy Policy: Terms and Conditions and Privacy Policy: I agree and understand the Terms and Conditions and Privacy Policy. I agree to fully release and hold harmless, Flora Mae Stafford (Growth Teacher) from and against any all and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).

Filming Consent Filming Consent I hereby consent to being filmed during the Session. I understand that the footage may be used for educational, promotional, or other purposes as determined by the Practitioner.

Today's Date in DD-MM-YYYY

Where did you hear from us? Where did you hear from us?YouTubeTiktokRumbleNostrUpscrolledGoogle BusinessWord of mouthXGoogle SearchGrowth Teacher NewsletterRedditInternet

Name of Your Trusted Friend or Companion