Begin your transformation
Complete your details below, choose your programme, and book your session. Ayesha works with clients in-person in Dar es Salaam and worldwide via Zoom.
Complete your forms
then book your slot
Please complete all sections below. Once done you will be directed to pay and choose your appointment time on Google Calendar.
If you have already completed your details and disclaimer in a previous booking, tick the box below and enter your email — the form will disappear and your session booking will appear instantly.
Please complete all required fields. This information is confidential and helps Ayesha prepare your personalised session.
1. Nature of services
Ayesha Samji offers integrative wellness coaching, mindfulness-based therapy, somatic movement guidance, yoga therapy, and health coaching. These services are complementary and integrative in nature and are not a substitute for medical diagnosis, treatment, or advice from a licensed physician or mental health professional.
2. Not medical advice
Nothing communicated during sessions constitutes medical advice. If you have a diagnosed medical condition, you are encouraged to continue working with your healthcare provider alongside this programme.
3. Your health & safety
You confirm that you have disclosed all relevant medical conditions, medications, and health history accurately in the form above. You agree to inform Ayesha of any changes to your health during the programme.
4. Confidentiality
All information shared during sessions is held in strict confidence, except where disclosure is required by law.
5. Cancellation & late cancellation charge
Sessions must be cancelled more than 24 hours before the scheduled appointment time. If a session is not cancelled within this window, the full session fee will be charged and the session will be counted as completed and deducted from your remaining package sessions. By signing this form you expressly authorise Ayesha Samji to retain your session payment if cancellation is made within 24 hours.
6. 15-minute attendance policy
Ayesha Samji will wait a maximum of 15 minutes past the scheduled session start time. If you have not joined or arrived within 15 minutes without prior notice, the session will be considered a no-show, will be counted as a completed session, and the fee will be forfeited.
7. Session deduction policy
Each attended session, late cancellation (within 24 hours), and no-show will be counted as a completed session and automatically deducted from your remaining package sessions. No replacement sessions will be provided for late cancellations or no-shows.
8. No-show policy
Sessions not attended without any prior notice will be forfeited in full and counted as a completed session deducted from your package.
9. Refund policy
The Initial Consultation ($60) is non-refundable once the session has taken place. Package fees are non-refundable once the programme has commenced.
11. Recording & privacy
Sessions will not be recorded without your explicit prior consent. Your personal data is held in strict confidence and will never be shared with third parties.
11a. Email communications
By completing this form, you agree that Ayesha Samji may contact you by email from time to time with relevant wellness information, updates, upcoming retreats, training events, and Substack posts. These communications are occasional and purposeful. You may unsubscribe at any time by replying to any email or contacting Ayesha directly via WhatsApp.
12. Results disclaimer
Results vary between individuals and are not guaranteed. Transformation requires your active, committed participation.
13. Personal responsibility
You agree to engage honestly, take personal responsibility for your wellbeing, and understand that Ayesha Samji’s guidance supports — but does not replace — your own informed decision-making.
Select your payment currency — the relevant payment options will appear below.
USD Bank Transfer Details (via Wise)
Use your full name and programme as the payment reference.
Once you have completed all sections above and made your payment, your session booking buttons will appear below — one for each session in your programme.
💡 You do not need to book all sessions today. Each button opens the calendar independently — you can return to this page or use the link sent to your email to book sessions when you are ready.