Application: Counseling (Legacy) Name First Last Last What is your biggest challenge with healing, awakening or purpose? What are you looking for that you’re having difficulty finding? What is the number one result you want? What do you hope working with me will do for you?* Have you done any prior work with me? (Check all that apply) Read my book(s) Doing the Holding Courses Private Counseling Sessions Private Holding Sessions Personal Reading Ceremonies Apprenticeship Personal Sound Healing None Which courses have you taken with me? (Check all that apply) SHE - Doorway to the Divine SHE: 10 Emotional Needs of the Soul Breakthrough Healing System Healing the Inner Child Sound Healing for Wellness Mystic Dreaming Secrets of the Sacred Feminine Revealed OtherOther Do you know your spiritual gifts—and know how to best use them? What are you currently doing to support yourself spiritually and emotionally in your journey? In what ways are these choices helping you?* Do you feel confident in using your empathy and sensitivity to aid you in your healing and/or purpose? What kinds of work directly with me are you most interested in that are currently within your financial means? (Check all that apply.) * SHE interactive (live) course Private Counseling Private Retreat (in-person or virtual) Live webinar course w/ group mentoring Semi-private retreat (in-person or virtual) Vision Quest Other I choose to work directly with deeply dedicated individuals. On a scale of 1 to 10, how committed are you to getting your desired results now? Is there anything else you want me to know about your application? Your best email address for me to respond to your application Please remember to add the following emails to your email address book to whitelist them and insure you receive my reply: healinghelp@misahopkins.com and misa@misahopkins.com What is your local time zone? Skype ID (Optional) If you have Skype, it allows me to record our conversation for you. Skype calls are free or very inexpensive from anywhere in the world. Else we can send you a Zoom link for your call. Phone We only use this in the event that we have difficulty connecting via email or at the appointed time. If you are human, leave this field blank. Submit
