Session Intake Form Name * First Name Last Name Email * Date of Birth * Marital Status * Names/Ages of Children Occupation Medications If you smoke or drink alcohol, how much, how often? Have you experienced a Past Life Soul Regression before? * How did you hear about Krystle Shannon Soul Regressions? * Is there anything else you would like me to know? * Please refrain from alcohol and go light on caffeine the night before and day of session. The information I am able to recall about the spirit world and/or past lives during my sessions may be utilized by Krystle Mortimore for research, writing and speaking engagements to enlighten others as long as my name and contact info or any other identifying information is NOT used. By checking this box I agree to all the above. Thank you!