Discovery Call Intake Form
Please complete this short form to guide our session.
Personal Info
First Name
Last Name
Email
Phone (optional)
1. Have you experienced Reiki, Coaching, or Energy Healing before?
Please Select
Yes
No
If yes, briefly share your experience
2. What brings you here today (e.g., stress, clarity, emotional healing, energy shift)?
3. What area of your life feels most in need of support right now?
4. How are you currently feeling: physically, emotionally, or energetically?
5. What would you love to get out of our time together?
I understand this session is supportive and not a substitute for medical or mental health care.
Signature
Date
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Month
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Day
Year
Date
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