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Spots are limited and accepted on a monthly basis. Allow 3-5 business days to receive a response at your provided email.

Name

First Name

Last Name

Preferred Start Date

YYYY

Which of my programs are you interested in?

Elemental Alchemy Healing Program

Subconscious Mind Coaching

HTMA Testing

Single Appointments

What are your top 3 biggest health concerns right now?

How is your health being managed currently? (Describe any medical professionals, coaches, or self-treatment you are working with)

How would you describe your stress levels on a scale of 1-5? (1 is low stress, 5 is very high stress)

Briefly explain your answer to the above question.

Have you ever done any subconscious mind work? If yes, briefly explain.

What is your goal or intention in working together?

What country (and state) are you currently in?

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I understand that none of the information Kailee provides is medical advice

I understand that Kailee will contact me via email to set up a free 15 min discovery call