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Client Information

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Medical

To assist you effectively, I will refer to your Astrology and Human Design charts. Kindly share your birth details:

Enter your birthdate with dashes and zeros eg: 07-07-2025
Town + Province + Country
Using 24-hr clock. (If unknown, use 1200 and check Time Unknown) ** This detail is important - relatives and baby books can be good resources.
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  • Thanks for trusting me. I’m committed to giving you excellent care and attention.

  • Many feel better after one visit, but the best results come from multiple sessions building on each other for lasting health in body, mind, and spirit.

Confidentiality

  • Your information is confidential and used only for healing services. I’m not a licensed medical professional and won’t diagnose or treat medical conditions. By filling out this form, you agree to use your information for healing purposes.

Safe and Private Space

  • My space is safe and confidential. Privacy and trust are a priority, and your information won’t be shared.

  • Your time here is protected and respected. Appointments are scheduled for your privacy, with time between clients for energy cleansing.

Your Appointment

  • Arrive a few minutes early—I’ll be ready. I prepare for your visit and will contact you if you’re late, as I care about your well-being.

  • Please give at least 24 hours’ notice to cancel, or the full fee may be charged. Sessions last one to two hours; let me know if you need to leave early.

How to Cancel or Reschedule

  • Cancel or reschedule online via the link in your confirmation/reminder.

How to Pay

By submitting this form, I confirm I’ve read and understand this policy. I’ll inform the therapist of any new conditions during treatment. I acknowledge treatments may cause emotional release, cold symptoms, or tiredness, and I release the therapist from any uncomfortable results.

If your form details remain after clicking 'SUBMIT' please fix the error above. When the form resets to blank, your details have been received.

Get In Touch

Email: [email protected]

Address:
605151 River Road

Melancthon, ON, L9V 2V4, CA

About Us


Holistic Healing, Personal & Professional Development

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605151 River Rd, Horning's Mills, ON L0N 1J0, Canada