HEALING FOR YOUR ENTIRE LINEAGE

Sacred Service Scheduling Intake Form

Please understand: This form is to submit an initial REQUEST for Scared Service.
Notice: Once Intake Scheduling Form is reviewed and you are accepted as a Client, instructions on how to submit Security Deposit will be sent to your preferred form of communication [text or email]. A standard 30% Security Deposit must be submitted before Official Confirmation receipt is sent to the Client.

Tell us your preferred Name? *

What day would you like your service? *

What are your main concerns or the trouble areas that you desire to address? *

If your issue does not improve soon where do you see your Self in 1-3 years?

How does your situation effect the other people in your Life?

Are you battling any demons at this time? *

Yes
No
I don’t know

If so, which Demon(s)? If you’re not sure then, “What Type of Demon(s)”?

Considering your specific concerns, what would Healing finally look like for you? *

Describe your overall goals for receiving this service you are requesting *

How would you like to be contacted? (phone recommended) *

Enter Phone Number

Enter Email

Please enter the name of your Social Media Account handle (e.g. Instagram, Facebook). This helps us learn a little more about you in order to prepare for your unique Energy. This also helps protect our Energy from those who need to heal themselves first.

Feel free to Upload Files of any relevant portraits of your Self, photo(s) of your trouble area(s), X-rays, voice messages, etc.

Who referred you? Or how did you learn of ALL HEALING HANDS? *

Did you complete the Consent Form below? Do you plan to Download & Print it to bring with you completed? Do you plan to Email a completed copy to us at contacttemple@allhealinghands.com? Or do you plan to fill it out when you arrive? *

" It's important to remember your Healing actually began the moment you committed to receiving treatment, so intentionally pay close attention to how your Body-temple has been responding to that decision. Be ready to share with me what you discover leading up to our special day together.”

GENERAL CONSENT For Customized Healing Pdf

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