Your Energy Healing Session

I am so happy to work with you and to see what we can accomplish in our energy healing session! I will be in touch with you to schedule our appointment shortly after I receive this questionnaire from you. This will give me an overview of what is happening for you.

What you can expect in your session: I will take the information you have given me on this page and tune into your energy and see what is needed to facilitate a clearing and healing with the areas you are having the most difficulty with. I cannot tell you exactly what the outcome of your session will be as this depends on your willingness to be open and receptive to the healing and also to following up with the instruction and information that your Guides, Angels and Teachers have to share with you. Just know that each of us are unique!

Full Name:



Telephone #:


1. Do you meditate?
 Yes No

If so, how often?

2. Give me a brief description as to any other practices you do?

3. Are you new to healing, or spiritual work?

4. What would you like to know more about?

5. If you are new to meditation, healing or spiritual practices, what attracted you to it?

6. Do you have a physical problem that you need help with?
 Yes No

If so, give me a brief description of the problem.

7. How long have you had this particular physical issue?

8. Did you suffer any physical, or emotional traumas that figure into this?
 Yes No

If so, describe it to me.

9. What, if anything are you doing to facilitate healing for this issue?

10. If you are not new to healing or spiritual practices, tell me what practices you are now doing and how long?

11. Do you feel stuck or blocked?
 Yes No

If so, can you give me a brief description of what is happening for you?

12. Give me a brief description of what you feel you would like me to help you with.

Disclaimer: Spiritual healing and energy work are not a substitute for traditional Medical treatments. If you have a serious health condition please see a Doctor or other appropriate professional, and make complementary healing part of a complete health care program. I do not diagnose any physical or mental conditions but offer spiritual information by invoking your Guides and Angels for information that is relevant to the clients personal spiritual path and healing. I find that energy healing used as an adjunct to traditional medical healing does accelerate healing and recovery time. My primary effort is to help others discover, acquire and activate their own abilities to heal themselves.

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