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Energy Healing Intake Form
First name
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Last name
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Email
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Do you understand that it is advisable to see a qualified doctor if you suffer from a physical, mental or emotional problem?
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Yes
No
Do you understand that a professional Energy Healer / Kundalini Activation Facilitator will not diagnose or recommend any form of treatment.
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Yes
No
Do you take full responsibility for your own Healing Journey and agree that this session is not therapy and a replacement for medical treatment with a doctor.
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Yes
No
Do you give me permission to work with your energy/subconscious mind energy *
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Yes
No
Do you understand that if a request to The Karmic Board /The Lords of Karma is required that it will be facilitated as part of your Session?
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Yes
No
We recommend that you eat light foods after an Activation. This is to limit purging possibilities. Can you commit to that?
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Yes
No
Hydrotherapy – Drink plenty of water before & after a session is highly recommended & soaking in Epsom salt bath or Bathing your feet in Epsom salt for 15 minutes min (3 days) supports the body further detoxify. Can U commit to doing this?
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