Top

Congratulations on Taking Action!

Spiritual Breakthrough Program Request Form

If you’re not ready to fill out the form right now, no problem. Just click the blue “Access your purchase” button on your email receipt, and it will take you back to this page whenever you’re ready!

My Spiritual Healing work is done working together with my Spiritual Team – a special committee of Spirit Guides, that works at higher levels of consciousness with your High Self and your Soul. Working synergistically, we research and clear negative programs and blocks from your Akashic Records, activate your 24 DNA Strands, and activate all 8 of your Sacred Geometry Symbols. Because all of the work is done through Spirit, you don’t need to do anything special during your Spiritual Breakthrough Program.

Your Spiritual Breakthrough Program will usually be completed within a week of my receiving your information. After I do your healing work, I’ll send you an email with your complete Clearing Notes, including the discordant programs in your Akashic Records that were researched and cleared and your Sacred Geometry Activation notes, as well as access to a private page on my website with information about the 8 Sacred Geometry symbols.

Your Spiritual Response Therapy Clearing includes clearing up to 3 issues. Here are some areas of your life for you to reflect on:

  • Relationships – family, friends, romantic, colleagues. List anyone with whom you have a challenging relationship, or have a relationship you would like to improve. Please note that each relationship is considered a separate issue, which needs to be researched and cleared individually.

  • Physical/Health – food sensitivities, allergies or health concerns you have. Please be specific about the symptoms you’re experiencing and include any information you may have gotten from medical professionals.

  • Mental/Emotional – challenges you’re having, such as fear, anger, guilt, depression, low self-esteem, anxiety, addictions, etc. Please be specific about what you’re experiencing and what is causing it. For example, don’t just ask me to clear fear or anger. Let me know what you’re afraid of or who/what you’re angry at – what triggers those feelings.

  • Finances/Money – financial challenges you’re experiencing, areas around money where you feel blocked. What are your financial goals?

  • Career/Creativity – career challenges you’re experiencing, any areas in your career or creativity where you feel blocked. What are your career goals?

These are general areas for you to reflect upon, to decide on 3 issues that you would like cleared. 

Note: An area of your life is not an issue. For example, if you have several health concerns, each one would be considered a separate issue that needs to be researched and cleared. They cannot all be cleared together as a single issue of “health.” Or, if you have relationships with several different people that you would like cleared, each relationship needs to be researched and cleared individually. They cannot all be cleared together as a single issue of “relationships.”

If more than 3 issues are submitted, I will check with my Spiritual Team to prioritize the top 3 issues to be cleared for you. If you have any questions, about this, please send an email to [email protected].

Please fill out the form below for your Spiritual Breakthrough Program. If you would prefer, you may email your information to me at [email protected].


Your Spiritual Response Therapy Clearing includes clearing up to 3 issues. Please list them below:


By submitting my information, I am requesting these healing services be provided for me, and acknowledge that I have read and agree to the Terms of Use and Privacy Policy.

*Indicates a required field.

error: Content is copyright protected.