Ember Body Application

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Name* This field is required.
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When I feel anxious or panic this happens to me:* This field is required.
I can feel my heartbeat either loud or fast
I feel dizzy or lightheaded
I feel buzzing or tingling in my body
my whole body feels like it's on fire
My arms and neck feel like it's on fire
I immediately want to distract myself
I freeze and can't think
My mind loops on anxious thoughts
My stomach gets nauseated and I lose my appetite
My throat gets tight and feels constricted
My chest gets tight and it feels hard to breathe
I have diarrhea
I need to lie down and rest
I need to move - walk/exercise/jog/dance
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I understand that there are no refunds for this educational class on anxiety, and I certify that I have made the choice as a self-responsible adult to opt in and make this purchase.
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By selecting "yes" below, I certify that the information provided in this intake form is true, accurate, and complete to the best of my knowledge and belief.* This field is required.
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Liana Russo, L.Ac., is a licensed medical provider who follows HIPAA privacy standards. By choosing “Yes” below, I understand that anything I decide to share in this group educational class is my choice and shared with my consent. I also understand that the class may be recorded and shared later for educational purposes.* This field is required.
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ORDER SUMMARY
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Ember BodyA 5 part educational class on Anxiety and how to use Eastern Medicine principles and techniques to work with your own body, energy, and emotions.
$333.00Edit
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