Skype Intake Form

So that I can best serve you and ensure you get the most out of your experience during our time together, please fill out all questions on the intake form to the best of your knowledge. I look forward to sharing your journey.

Much love, Emma Beth

 
Personal Info
Name *
Name
Personal History
Are you pregnant? *
Do you expect to be menstruating during your session? *
Do you have any physical or mental limitations, injuries, or restrictions that might impact your session? *
Our Session
What to expect from your Skype session: We will start with a period of discussion so that I can understand your needs and create a customised healing experience for you. The session will begin with a brief connection through a soft eye gaze. This will open the doors for us to access your healing and awakening during our session. The remainder of the session will be carried out with you either laying down or resting in a reclined seated position. As the main part of the session comes to a close, there will be a period of integration and grounding to prepare you for re-entry into your life with a renewed perspective.
Declaration
I understand that the session(s) I receive is/are provided for the purpose of healing, releasing, awakening, and reclaiming wholeness. If I experience any pain or discomfort during the session, I will immediately inform the practitioner. I further understand that the sessions(s) should not be construed as a substitute for medical examination, diagnosis, or treatment. I understand that my practitioner is not qualified to diagnose, prescribe, or treat any physical or mental illness and that nothing said in the course of the session given should be construed as such. I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my profile and understand that there shall be no liability on the practitioner’s part for any reason whatsoever.