Before we meet

Time Zone Required

What time zone will you be in for our session?

Month Born Required

Birthday Month

January · February · March · April · May · June · July · August · September · October · November · December

Town, State, Country Required

Town, State & Country Where You Were Born

Time You Were Born (am/pm?) Required

Please just type in your birth time, do not worry about the time zone. Just mark your birthtime at the place you were born.

Your Platform

Website, Instagram handle or YouTube (if you have one):

Session Type? Required

What session are you interested in booking or starting with?

One on One Session · Clearing Session · Astrology/Human Design Blueprint Reading · Galactic Starseed Origin Reading · QHHT or Past Life Regression · I don't know, I need help figuring this out

Main Purpose Required

In your own words, what is calling you toward this next spiral of growth?

Desired Results? Required

When you imagine your life fully aligned with your Eternal Self—what do you see? (Let this be expansive. It can be described through visuals, tone, mission, or daily feeling.)

What Resonates With You?

What areas are you most wanting to explore, refine, or embody at this time?

Divine Timing & Success Codes · Leadership & Expression · Relationship to the Body or Health Pathways · Reconnection with Divine Source Identity · Business as Mission (Soul Business) · Galactic or Interdimensional Remembrance · Energetic Clean-Up / Field Clearing · Quantum Wealth & Receiving Flow · Soul Purpose & Soul Confidence · Other

Beliefs Required

Briefly describe what main spiritual beliefs or programs shaped your early life and what are your spiritual or religious beliefs and/or your life philosophies now.

Childhood Dream Types & How You Dream Now Required

As a child, did your have unique experiences such as vivid dreams, fear of the dark, feeling as though you were being watched or dreams of falling? Please share anything that stands out to you.

Mother Required

How would you describe your relationship with your mother or maternal guardian?

Father Required

How would you describe your relationship with your father or paternal guardian?

Siblings Required

Do you have siblings? And if so how many and what position are you in the birth order? How is your relationship with them if you do have any?

Children? Required

Do you have children?

Yes · No

Dream Goal Required

With all that you have shared, what is the biggest goal you are holding right now? The dream you are wanting to manifest or on the road to manifesting? And if there was something that you feel would be the biggest game changer for you if you could unlock it's energy in you life, what would that be?

Where are you right now with your goals?

Which of the following feels most true for you right now?

I’ve been activating a new layer of purpose and am ready to ground it. · I feel a breakthrough on the edge of my field and want support clarifying or stabilizing it. · I’ve come a long way, but something subtle keeps limiting full embodiment. · I’m hearing the call to step into a new leadership frequency. · I’m ready to see what I couldn’t see before and walk through a new door. · Every phase is sacred, even when we feel lost or uncertain about the answer, if none of the above feels like the right answer, please fill in the blank and share where you are.

Consent Signature Required

⚪PLEASE READ AND SIGN:⚪ Thank you for choosing to enter this sacred work. This is not just a session—it is an initiation. Before we begin, I invite you to align with the following terms of participation. These words serve as our energetic agreement, rooted in clarity, sovereignty, and mutual devotion to your evolution. ⚪ This Work is Not a Substitute for Medical Care The energy modalities and soul-based practices offered here—including soul coaching, regression, meditative journeying, energetic attunement, and remembrance activation—are powerful catalysts for transformation. However, they are not designed to diagnose, treat, or replace licensed medical, psychological, or psychiatric care. ⚪If you are under the care of a healthcare provider, please continue to follow their guidance alongside this work. Your physical and emotional well-being are sacred—and you are always your own best advocate. ⚪ Client Acknowledgment By signing or submitting this form, I affirm the following: – I understand that I am a co-creator in this journey, and my level of presence, willingness, and honesty shapes the depth of what unfolds. – I recognize that all outcomes are unique, and no specific result is guaranteed. – I acknowledge that this work is spiritual and energetic in nature, and is not intended to replace medical treatment or mental health care. – I take full responsibility for my choices, emotions, thoughts, and actions—during and after the session. – I understand that my free will is always honored. I may pause or end the session at any time. – I agree to respect sacred timing, including punctuality and a 24-hour notice for cancellations or reschedules. – I trust that all shared experiences are held in deep confidentiality, including for youth participants (with ethical guidance observed). – For in-person sessions, I consent to gentle, non-invasive touch if needed for grounding or guidance (e.g., hand, shoulder, wrist, forehead). ⚪ Empowered Participation - I choose to enter this field: – In full responsibility for my energy. – Willing to see what is ready to be revealed. – Open to shifting what no longer serves. – With respect for the sacred nature of this space and the guidance shared. “I walk in awareness. I co-create in freedom. I am ready to remember why I came.” E’stA Un’TA E’-Sa – So it is. Always.

This is a reclamation journey. You are remembering. Thank you for taking the time to read and sign this. Everything you share in this space is held in deep care and confidentiality. I am honored to walk beside you on this journey of remembrance, healing, and inner freedom. With gratitude and Omni Love, Becca