Residential New Construction - Reiko Home by Reiko Gomez - Feng Shui Designer

Your Full Name:

Address of building or property (include zip code):

Address Line 1

Address Line 2

City

State

Zip Code

Your mailing address (if different from above):

Address Line 1

Address Line 2

City

State

Zip Code

Best phone number:

Email:

Birthday

Are there additional family members who will live in the house? If so, list their full names and birthdays (month/day/year):

Projected year the house will be built (if known):

Direction the front of house will face (if known):

What would you like to get out of a Feng Shui consultation?

What are your goals in the following areas:

1. Health / Fitness

2. Romantic Relationships

3. Family relationships and Children

4. Friendships

5. Career

6. Wealth / Financial Security

7. Fame / Public Recognition / Reputation

8. Education / Self-development / Spiritual Growth

Which of the above areas are most important to address right now?

What do you consider your strengths?

Where do you feel you "get stuck" in life?

What, in your life, have you been putting up with (either unwilling or unable to change)?

What, in your current home, have you been putting up with (either unwilling or unable to change)

How long do you see yourself living in your new home?

When you think of your life 5 years from now, what would you like to see change?

Do you have a long-held dream that you would like extra support around?

Is there anything else you would like to share? (All information is confidential)

MY COMMITMENT TO YOU:

I am committed to helping you achieve your goals and live your dream by providing the best Feng Shui possible. I will do my best to listen to you and your needs and provide specific recommendations that will produce powerful results.

Your analysis will include an advanced Feng Shui reading of your space, analysis of the layout, and detailed recommendations for optimal health, wealth, and harmonious relationships.

While my goal is to help you get the most from your consultation, I cannot promise specific results nor be held responsible for what happens within a space or to its occupants after my recommendations have been implemented.

By returning this questionnaire along with payment, you confirm that you have read and agree to the terms of our working relationship. Thank you for choosing to work with me, and I look forward to getting started!

DOCUMENTS REQUESTED PRIOR TO CONSULTATION

1. Completed Feng Shui Questionnaire
2. Full payment
3. Floor plan of the proposed house
4. Photos of the property (wide shots, including one photo from the street looking toward property, and photo on the property looking towards road)
Thank you!

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What are your goals in the following areas:

MY COMMITMENT TO YOU:

DOCUMENTS REQUESTED PRIOR TO CONSULTATION

Get into the Flow