Initial Intake Form

Feminine Brilliance Temple

Your Introduction with Dr. Wangmo
We are pleased to have you with us.

Please take your time and fill out the introductory questionnaire.

I will contact you personally and we will set up best time to connect.

New Clients Only. Cheers.

Your privacy is important to me, your email will never be sold or shared with anyone.

May All Sentient Beings Benefit

བྱམས་པ བཏང་སྙོམས་ སྙིང་རྗེ་ དགའ་བ་
Full Name*

First NameLast Name
Profession*
Date of Birth*

MonthDayYear
Place of Birth, Country & City
For astrological reading
Time of Birth
For astrological reading
E-mail*
Gender*

FemaleMale
What is your Skype Id?*
For our sessions
Have you taken any workshops with Dr. Wangmo in the past?
How Can I Help You?
Please tell me what draws you to Buddhist, Vedic, Yogic Counsel at this moment?*
What are the biggest aspirations you hold for your life at this time?*
What habits and beliefs are getting in a way of living your clearest feminine/masculine espression?*
What do you hope to receive from our time together?*
What other modalities of healing do you/have you used? List all that applies.*
What are your Spiritual/Religious Beliefs? Ex: Judaism, Islam, Christianity, Hinduism, Buddhism etc..*
What is your spiritual background? What experience do you have with spiritual awakening?*
What experience do you have with teachers/mentors/coaches?*
What Else?
What else would you like me to know about yourself?*
Do you have any questions for me?*
Enter the message as it's shown*
Please type in your name, to indicate that the information you have provided is true, and that indeed you are the person you claim to be.*
Electronic Signature
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Feminine Brilliance Temple

How Can I Help You?

What Else?