Problems and Solutions List for Consciousness Infusion Service

Before the service, list your major problems, in the first column. As you get insights or solutions to the listed problems, either during the service, after, or maybe upon awakening the next day, write them down in the second column. Write required actions and when you will do them, if necessary, in the third column. When you have completed the actions, check them of in the fourth column. When you are done with the session and filling out this form, transfer the information to the 5 Minute Feedback Form and click SEND immediately. Date / /
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