Name
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First Name
Last Name
Email
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Phone
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(###)
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What is the primary reason for your inquiry?
Session Location
New York City
Hudson Valley
Virtual
Other
What do you need support with?
Why is this a priority for you now?
What would it mean to unlock this possibility?
What are your biggest fears in achieving the life of your dreams?
I give permission to have a private session administered by touch - either virtually or in-person.
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The session, and Reiki System of Natural Healing session is classified as spiritual healing. The session does NOT take the place of medical treatments or advice. I understand that there are no claims or guarantees of healing or curing disease.
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I agree to Covid-19 safety protocol, including hand-washing, sanitation, mask usage, and contact tracing if applicable. Should I become ill or experience any symptoms of Covid-19, I will alert the practitioner immediately.
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To verify you, please provide a link that can confirm your identity (Linkedin, Instagram, Facebook, etc.)
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What, if any, health concerns are you currently receiving treatment and/or medication for?
What areas of your body do you tend to hold tension or stress?
Do you have any sustained injuries? Did they require medical attention or surgery?
Do you have any chronic conditions?
Are you currently receiving any other forms of treatment from holistic or health care professionals? (i.e. acupuncture, herbs, homeopathy, prescription drugs, supplements, psychotherapy, nutrition program, etc.)
Any additional notes that would be helpful for the practitioner?
