Forms
You may print the relevant forms from below and submit to Spiritual Arts the scanned copies of the duly filled forms:
Admission Form for Spiritual Arts Courses
Today’s date:
First Name:
Middle Name:
Last Name:
Admission Approved? Yes /Not yet (Fill up the form ideally after getting the admission approved by Dr Daisy V Shah)
Sex : Female /Male
Marital Status : Single /Married
Education:
Occupation:
Telephone No:
Mobile No:
Mailing Address (complete address please):
Pin Code:
Email:
Course applied for: Spiritual Arts One /Two /Three /Specially Designed course for a group of 10 people or more (Give details) /Personal Training Program (Give details)
Any Medical Problems?
Have you discontinued any medications for psychological condition/s?
Reasons for applying for the course:
How did you know about Spiritual Arts and Daisy? (select only one)
I am a past client
Client referral
Other practitioner referral
Google search
Yahoo search
Internet search
Newspaper articles
Magazine articles
Other (specify)
Fees paid: Fees pending:
Course begins on:
Place Signature Date
I apply for the above-mentioned course. I declare that I am fully capable of undergoing this course. I shall not hold any claim /responsibility on the trainer of Spiritual Arts Pvt Ltd or on their directors and employees for any damage /harm that may result from this course /the application of this course.*
__ Place Signature Date
*Spiritual Arts has to cautious due to inability of some people in understanding and applying the knowledge imparted in the courses and due to the people who want to consider mystic knowledge as merely scientific.
We also need your two passport-size photographs.
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Consultation Request Form
Today’s Date:
First Name:
Middle Name:
Last Name:
Date of Birth : (DD) (MM) (YY)
Time of Birth : (Hour) (Min.) AM/PM
Place of Birth :
City of Birth :
State of Birth:
Country of Birth :
Sex : Female /Male /Misc
Mobile No:
Mailing Address (complete address please):
Pin Code:
Email:
Consultation applied for:
Astrology, Numerology, Graphology and Tarot
Vastu
Karma Consultation
Spiritual Counseling
Graphology for recruitment
Horoscope
Aura Reading
Although we ensure the total confidentiality of the consultation content and your identity from our side, do you want to make sure that no other people be present in the office while you visit? (This service will be provided at five times the original fee) Yes /No
Fees Paid:
How did you know about Spiritual Arts and Daisy? (select only one)
I am a past client
Client referral
Other practitioner referral
Google search
Yahoo search
Internet search
Newspaper articles
Magazine articles
Other (specify)
I apply for the above-mentioned consultation. I shall not hold any claim /responsibility on Spiritual Arts Pvt Ltd, its employees and directors for any damage /harm that may result from the application of this consultation.*
Place Signature Date
*Spiritual Arts has to cautious due to inability of some people in understanding and applying the knowledge imparted in the consultations and due to the people who want to consider mystic knowledge as merely scientific.Thank you!
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PERSONAL HEALING REQUEST FORM
Today’s Date:
First Name:
Middle Name:
Last Name:
If possible please send a recent photograph of yourself/the person the healing is requested for attached as a .gif or .jpg file by separate e-mail (spiritual.arts@yahoo.com) addressed ‘To Dr Daisy V Sha(h) for healing of (patient’s name)’
Mailing Address (complete address please) with area code:
Phone:
Mobile:
Email id:
Do you want to place a request for healing? Yes/ No
Is this your first request of healing at Spiritual Arts? If yes, skip the next section
Make sure that you clear your payments before filling up this form.
Fill the following data (This information will help us decide on the healing methodology better):
When did you request your last healing at Spiritual Arts?
When was your request processed by our healers?
What was the healing requested for?
Which of the following healing plans you chose?
1 healing times
5 healings times
10 healings times
15 healings times
What did you feel during the healing/s?
Did you feel any effects afterwards which you would attribute to the healing/s? Yes /No
If the answer is yes, on which level did you feel the healing/s?
(You can check more than one level)
Physical
Emotional
Mental
Spiritual
Other
If the answer is other, please describe:
How soon after the healing request was processed did you start to feel the effects?
For how long did the effects last?
Please rate how beneficial the healing was to you:
Very beneficial
Beneficial
Hardly beneficial
Not beneficial
Others
If the answer is others, please describe
After your healing/s was/were processed, did you notice any change in your life, or did any special event happen that you feel important mentioning? Yes /No
If the answer is yes, please give details:
Did you follow the healing suggestions specifically given to you? Yes /No / Partially
If the answer is yes or partial, please share your feedback & experiences with these healing suggestions
Did you do the healing exercises as outlined for you? Yes/ No / Partial
If the answer is yes or partial, please share your feedback & experiences with the healing exercises
If the answer is no or partial, please share why you choose not to use the healing exercises
Would you like to make any other comments?
What is the healing requested for?
Choose one of the following healing plans (You may opt for a healing plan multiple times at a time. For example you many opt for 1 healing for 3 times):
1 healing times
5 healings times
10 healings times
15 healings times
Please decide on the approximate number and frequency of healings after talking to Dr Daisy V Sha(h).
It is always better idea to opt for a Grapho-Numero-Astro-Tarot consultation with Dr Daisy V Sha(h) before you start receiving healing. The suggestions and guidance there will be something that you can yourself follow to improve yourself and your situation (apart from healing suggestions and healing exercises plan – at times it is better to get pro-active in the face of difficult energies). During this consultation, you may be advised to opt for karma consultation and /or spiritual counseling and /or Vastu consultation, instead of /along with healing. If it is found that rather some other sort of healing modality will be appropriate for your kind of energies, you’ll be guided accordingly.
Also don’t forget to get healing suggestions and healing exercises plan.
You may also fill up the Healing Feedback Form after receiving just one healing from any healing plan.
All of the above information will be treated strictly confidential and not passed on to any third party.
Place Signature Date
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