Hahnemann Healing

–Personal Information–

By checking this box you consent to receiving emails/texts regarding your appointments.

–Additional Information–

Have you had Hahnemann Healing before?

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–Medical information–

Have you been diagnosed with a mental health condition? E.g. clinical depression, schizophrenia, bi-polar disorder, borderline personality disorder, addictive disorder, eating disorder?

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Have you seen a psychologist or psychiatrist?

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Have you ever been hospitalized for an emotional illness?

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Are you still triggered by previous trauma?

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Are you pregnant?

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Are you currently seeing any other healing or health practitioner/advisor?

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Please indicate if you have any of the following applicable conditions:

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–Client Consent–

During a session of Hahnemann Healing you will be touched on various parts of your body by my fingertips and/or hand. You will remain clothed. Do you give consent for me to touch you as above?

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I am trained to recognise emotions connected to physical ailments and where on the body to best heal these emotions. I do, however, make no promises or affect any guarantees that Hahnemann Healing will heal you of any ailment or achieve any particular outcome. The healing I offer is not intended to replace or be a substitute for medical advice and care.

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If you are under 16 years of age, parent or guardian name and signature of consent

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