Feng Shui, Holistic Health Home Consultation Questionnaire

Please fill out this questionnaire and I’ll respond to you by phone or email. I’ll explain how a Feng Shui consultation works and go over my fees. If you desire a holistic home health consultation, please fill out the bottom 3 questions. To get started right away, please call me at (919) 451-2601 to discuss your questions and to set up an appointment.

Name (required):

Email (required):

Phone Number (required):

Street Address:

City, State, Zip:

Requested Consultation Date:

Requested Consultation Time:

Do you have an office or operate a business from home?
OfficeBusinessN.A.

If so, name of business:

Also, type of business:

Are you
MarriedMarried with ChildrenSingleLiving with Someone

How many people live in your home?

What type of home do you live in?
Single Family HomeCondoApartment

What is the square footage?

How did you hear about Tranquil Flow Holistic Interiors and Feng Shui?

Have you ever had a feng shui consultation before?
YesNo

Briefly describe your present situation and what you would like to accomplish with this consultation:

How long have you lived in your home?

Where did you live before?

Why did you move?

Describe the experience of finding your home:

How old is your home?

Is anything broken, not working properly or in need of any type of repair? If so, for how long?

Do you know who lived there before you? What was their life like? Why did they leave?

What is the history of the home?

In a few words, briefly describe your neighborhood:

Are there any schools, churches, hospitals, large commercial properties, parks, lakes, playgrounds, major highways or electrical transformers near you?

How would you describe your life since you moved into this home? While answering, give some consideration to: health and well being, career, knowledge, family, wealth, fame/reputation, marriage/relationships/parnerships, children/creativity, helpful people/travel.

In what areas of your life are you most satisfied?

In what areas of your life are you least satisfied?

What are your top three goals for this feng shui Consultation?

Goal 1:

Goal 2:

Goal 3:

Is there any other reason for your consultation?

Additional questions for those seeking holistic home consultations

Do you have any specific health concerns at this time?

If yes, when did the problem start?

Do you have a diagnosis from your physician?

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