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Rooted in Nature
Apply Today to Begin Your Journey of Transformation and Self-Love.
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Name
*
First
Last
Email
*
What brings you to this healing session?
(e.g., physical pain, emotional challenges, stress relief, limiting beliefs)
What specific outcomes or areas of focus are you hoping to achieve?
Have you experienced energy healing before?
Yes
No
Do you have any current physical or mental health conditions you'd like me to know about?
Are you currently on any medications or undergoing other treatments?
(Yes/No + Details if Yes)
following? session? you
Are you experiencing any of the following?
Chronic stress
Difficulty sleeping
Anxiety or depression
Chronic pain
Other
Do you have any preferences for the session (e.g., music, silence, guided visualization)?
I understand that energy healing is a holistic practice and does not replace medical treatment.
Yes
No
I agree to communicate openly and responsibly about my needs during the session.
Yes
No
Begin Your Healing Journey