Tamara Edwards
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ACTIVISM
BE Society
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Home
Shop
Events
services
About
Testimonials
Interviews
Tamara Edwards
ACTIVISM
BE Society
Name
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First Name
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Email
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Date of Birth
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Home Address
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City
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How did you hear about my work?
Are you on any medication? Please explain.
Do you take recreational drugs? Please describe.
Do you have a history of mental illness yourself or in your family history? I.e Paranoia, schizophrenia, bi polar, mania, depression, etc.
Have you meditated before? If yes, please describe.
Have you ever practiced breathwork? Please describe.
Do you exercise? How often and in what forms?
What do you hope to get out of our sessions together?
Anything else you would like me to know?
On a scale of 1 - 10 ( with 1=Never, 10=All the time) please rate how much of the time you experience the following:
Anxiety
Overwhelm
Strong emotions
Restricting food
Binge eating
Reactivity
Depression
Fear
Thank you!