Healing Touch Intake Form Name * First Name Last Name Email * Have you had energy healing before? If so, what type? What is prompting you to schedule a Healing Touch session? What are you hoping to get out of it? * Any allergies? * Any illnesses, surgeries, or injuries? * Please list any current pharmaceutical or herbal medications * Length of Session * 90 minutes is recommended for the first session to allow time for a thorough intake. 60 minutes 90 minutes Thank you! I’ll contact you shortly.-Rebekah