Liminal WomanQUESTIONNAIRE Name * First Name Last Name Email * Date of Birth * MM DD YYYY Exact Location of Birth * Exact Time of Birth * Do you have a partner? * Yes No Do you have children? * Yes No Choose an Element. * Earth Air Fire Water Ether Choose a Color. * Purple Blue Green Yellow Orange Red Choose an Animal. Dove Dolphin Turtle Snake Hawk Lion Please list the parts of your physical body that cause you pain or discomfort. * In a few sentences tell me how you would describe your Father.. * In a few sentences tell me how you would describe your Mother. * Please share below any other information you feel I should know or would like to share. * Thank you!