Empath Healing Session Form

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Name* This field is required.
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Include Country Code, e.g., +1 for USAThis is optional! Only if you'd like, you can request a recommendation via WhatsApp voice note for any of my services or support for the online packages.
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Where did you hear us from?* This field is required.
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If you were referred, please let me know their name.
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Would you prefer a single session, package or online coaching?
Sacred Energetic Medicine: Single Distant Healing Session: This one-time session is dedicated to sending healing energy remotely. It’s ideal for clients seeking energy alignment or those interested in exploring healing through energy support without direct physical interaction.
Alignment Activations: Package (3 Sessions Over 3 Weeks): This includes three distant energy healing and two mini coaching sessions, allowing for more in-depth healing work over a set period targeting on something specific. It is designed for individuals who are looking for sustained support and deeper shifts in their healing process.
Online Sessions: In these real-time video sessions, we’ll gently guide you as you dive deeper into your healing journey, offering immediate feedback and personalized support. Between sessions, you’ll have access to ongoing support through email or WhatsApp, ensuring you feel nurtured and supported every step of the way. This continuous connection creates a safe space for your transformation, helping you feel empowered, aligned, and cared for throughout your healing process helping you embody the new you
I would like A recommendation
Other
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Let us imagine we are in session: Please describe one challenge you would like to focus on.* This field is required.You can keep this concise or expand if you are called. I would need the actual challenge and why it's holding you back
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Large
Normal
Small
Ok
Ok
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What would your ideal outcome at the end of the session be?* This field is required.This can be at all levels of health: Body, Mind, Emotions or Soul
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Ok
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How Many Hours A Week Can you dedicate to Your Journey?* This field is required.This includes sessions, follow-ups and implementing techniques such as meditation or journaling in your own time
1-2 hours a week
2-4 hours a week
4-7 hours a week
I will spend as much time as is needed
I do not have that much time
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How committed are you into putting gentle effort into achieve your goals?* This field is required.
Somewhat
Moderately
Very
I want to but I am going to need accountability and motivation. With this, I will put in the work.
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Are you ready to invest financially in yourself?* This field is required.
Yes! I am Ready to Begin.
I am Serious But I would need a Payment Plan
I Don’t Have the Finances Yet and Might Struggle to Invest Consistently
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Before I Book* This field is required.I would like Some Guidance:
Please Give Me An Email Recommendation
Please Give Me A Whatsapp Voice Note Recommendation
Let us Book A Call To See Which Option is Best (for online sessions only)
I Know the Session Mentioned Above Is Exactly What I need and Ready To Move Forward!
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Do you have any questions for me?This can be at all levels of health: physical wellness, emotional, spiritual, purpose, abundance or other.
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Signature: Please sign here to acknowledge that the information provided is accurate and complete.* This field is required.Scope of Services and Medical Disclaimer: Megan Bailey is a medical intuitive and energy healing consultant, not a physician or psychologist. The services provided focus on wellness, prevention, and holistic support rather than the treatment or diagnosis of specific medical conditions. If you suspect you have an ailment or illness requiring medical attention, please consult a licensed physician. Only a licensed physician can prescribe medication, and any mention of drugs or supplements during consultations is solely for understanding your current regimen and not for evaluating the appropriateness of your medication. Decisions regarding prescription changes should always be made with your physician. Megan Bailey’s approach emphasizes non-toxic, natural nutritional therapies and energetic practices to support optimal health and prevent illness. The aim is to educate and motivate clients to take personal responsibility for their health through a positive attitude, lifestyle choices, and dietary practices. All advice provided should be considered at your own discretion. Discussions about health conditions during sessions are on an energetic level and should not be interpreted as a medical diagnosis. These sessions are not guaranteed to cure or prevent illness. While many clients experience improvements in health and well-being, Megan Bailey does not guarantee protection from future health issues. By signing below, you acknowledge that you understand Megan Bailey is not a medical doctor or psychologist. You agree to seek medical attention if needed and recognize that Megan Bailey will not be held liable for any failure to diagnose, treat, or prevent illness. Confidentiality and Disclosure: You have the right to confidential treatment, and your privacy will be maintained. Confidentiality will be upheld unless client consent is given, or if there is a clear and imminent danger to yourself or others, or as otherwise required by law. If there is any intention of self-harm or if you are experiencing suicidal thoughts, it is your responsibility to seek immediate help from a licensed mental health professional or appropriate support services. Megan Bailey will not provide mental health crisis intervention and is not liable for failure to address such issues. You are expected to disclose any intentions of self-harm so appropriate referrals can be made if necessary. Payment and Cancellation Policies: The consultation fee is due before the session. Cancellations made less than 24 hours before the appointment will incur a charge. Communication and Support: Megan Bailey is available for brief, general support between sessions but cannot offer comprehensive assistance via email or outside of scheduled sessions. Acknowledgement and Responsibility: By signing below, you confirm that you understand Megan Bailey’s role as a spiritual mentor and energy healer, not as a medical or psychological professional. You agree to seek medical advice if needed and acknowledge that Megan Bailey will not be liable for any health conditions or failures to diagnose or treat illness. You commit to providing accurate information about your medical conditions and medications and release Megan Bailey from responsibility for your individual response to the energies and information received. Program Participation and Refunds: Payment for sessions should be made at least 3 days in advance to secure your spot. Any session cancellations should be made with at least 24 hours’ notice to avoid charges. If joining a program or group coaching, you agree that it aligns with your goals. Refunds of 50% are available within the first week of participation; no refunds will be issued beyond this period.
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Consent* This field is required.By checking this box and submitting this form, I hereby consent to receive email communications and promotional materials from Shed and Shift at the email address provided above. I understand that I can unsubscribe from these communications at any time by following the instructions provided in the emails*This field is required.
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