Nathalie Laforest

Energy Healing for You

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What circumstances would you like to create instead?

Have you ever had a Reiki or Energy Healing session before? Please describe

Date of Birth and Place of Birth *

Please submit this form before your Energy Healing Session.

Spouse/children’s names and date of birth if applicable

I understand that Energy Healing is a gentle energy technique that is used for stress reduction and relaxation. I understand that Energy Healing practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. I understand that Energy Healing does not take the place of medical care. It is recommended that I see a licensed physician or licensed health care professional for any physical or psychological ailment I may have. I understand that Energy Healing can complement any medical or psychological care I may be receiving. I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long term imbalances in the body may require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself. *

Agreed

Please describe your current circumstances that you would like to address in this session: Physical, Emotional, etc.

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Client Information Form

Current Name and Full Name at Birth *

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Current treatments, medications and special diet