NEW CLIENT INTAKE FORM

The information below is kept completely confidential

I am so excited to Feng Shui your space! With your Mati Feng Shui Consultation, I will guide you on how to create balance and harmony, by supporting and aligning your goals and needs with the energy within your space.

To prepare for your upcoming consultation, I will need the following items emailed to me at least five days ahead of your scheduled zoom appointment.

Please complete the attached intake form
Email a legible scan of a hand-drawn floor plans of your entire space.
Include locations of items such as stoves, fireplaces, bed(s), desk, doors (with swing) and windows.
Additional furniture and detail is ok to include as well.
Draw your floor plan as close to scale as possible and add any information listed above.
Sign your floor plan
Email me pictures of your space, please no more than 15

Once I receive all your information, I will use the tools and rituals of my practice to guide me in analyzing your space. Upon identifying what your floor plan tells me, I will then provide solutions for you and your space. During our consultation I will provide a more in-depth explain of these tools and rituals. Helping to build a better understanding of how the proposed solutions will help achieve your goals and needs.

At the end of our consultation, I will explain and ask for your participation in a final ritual known as The 9 Red Envelopes. This is an ancient Chinese tradition that reflects, honors and respects the transfer of energy between us and your sacred space.

Please do not hesitate to ask if you have any questions. I look forward to working with you!

Name

First Name

Last Name

Birthdate DOB

YYYY

Marital / Relationship Status:

Occupation:

Health History:

(which of the areas have you had issues with, if you have not had any, please say none)

Anxiety

Depression

Sleep issues i.e., insomnia

Vision

Other

Any personal issues that have been active over the past 6-12 months?

(i.e. career, relationships)

What would you like to work on personally in the next 6 months?

(i.e. career, relationships)

How would you describe yourself if you had to use only three adjectives?

(for example: fun-loving, anxious...)

What is your Strongest personal trait?

(do not think negatively, think of it as the one you most want to enhance)

If you could live anywhere, where would it be?

(for example on a beach, in a big city, in the mountains)

Describe your perfect day...

In addition to providing a floor plan, tell me more about the space

How long have you lived in or occupied this space?

What is your favorite thing about your space?

What is your least favorite thing about your space?

What do you want to do and/or improve within this space?

For a business, how do you feel in your office?

For a residence, how do you feel in your bedroom?

Please provide any additionnal relevant information about the space.

What do you know about the property’s history or former occupants?

Are you aware of any previous issues or problems?

Other (please specify)

Please provide Name(s), Birthdate(s) (month, day, year) for the people occupying the space with you.

For a business this could be employee’s, team members, partners, etc. For a residence this could be your familiy members, roommates, etc. Please make note of any personal relationships you have (past or present) with any of the people listed.

Things everyone in the space would like to work on personally in the next 6 months.

(i.e., relationships, career).

List the top three, in order of importance, collectively.

What three adjectives would each adult, on the list above, use to describe themselves?

(for example: fun-loving, anxious...)

What is the strongest personal trait for each adult on the list above?

(this could be their most dominant trait)

What is the weakest personal trait for each adult on the list above?

(do not think negatively, this is what they most want to enhance)