Client Consent Form
Informed consent to treat for Personal Energy Consultations/Clearings
Date of Birth (for Birthday Blessings!)
What is the main reason you would like a transformation session?
What are you hoping to get from the session?
Are you currently under a Dr.’s care or taking medications that I should be aware of?
Do you feel any of the following things? (please list any and all) Depression, anxiety, sadness, loneliness, stress, too muchsleep, not enough sleep, anger/rage, or confusion?
Have you seen someone for what we will be discussing?
Prefer not to say
Are you happy with your life? All or part?
Have you ever received energy healing? If so, what kind?
Do you have any questions, comments, or concerns for me?
By signing this document you are agreeing to all of the terms and conditions stated.
Should be Empty: