INFINITE LIGHT HEALING
Welcome
Healing Sessions
Craniosacral Therapy
Distance Healing
About
Intake Form
Contact/ Rates
Confidential Client Intake Form
If a question does not apply,
please write “none" or “N/A” in the space.
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Name
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First
Last
Phone number
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Date of Birth
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Occupation
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Address
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Referred by
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Children
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relationship status
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Have you ever received CranioSacral Therapy / Healing Session? If so, what has been your experience?
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Medical Condition
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Injuries, Current or Past
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Traumatic events you would like me to know about
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Medications and/or Supplements
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Current State of Being-How Are You Right Now?
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What Are Your Goals/Intentions for this session?
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Additional Information
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Kindly give 24 hours notice if you need to cancel or change your appointment. This courtesy allows me to schedule waiting clients. Except in cases of emergency, the cost of the session will be charged without 24 hour advanced notice.
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Agree
Submit
Welcome
Healing Sessions
Craniosacral Therapy
Distance Healing
About
Intake Form
Contact/ Rates