Client Intake Form(Step 1) Welcome to my practice!I would like to familiarize you with my session policies.Appointments are scheduled based on individual needs.If after I receive the intake and I get the sense that we are good to work together, we set up an appointment.Healing sessions are $225 per session. They usually run 90 min. If it's Compassionate Depossession then I like to do it via Zoom. All other sessions are either via Zoom, phone or remote.As soon as you book, your whole situation will be held by my Compassionate Allies.A deposit of half of the payment is due when the appointment is set, the other half is sent before the session via Venmo @Connie-Rogers-2 or PayPal— Homteamhealing@gmail.comI look forward to connecting!There are Pre and Post Session Suggestions on the FAQ page. I suggest giving yourself TIME for integration! Name * First Name Last Name Email * Phone * Country (###) ### #### Where are you currently located? * Date of Birth * MM DD YYYY Marital Status Single Married/Partnered Divorced Widowed Spouse/Partner Name Type of work you do * How did you find me or who referred you to me? * What is your ethnic ancestry? * Briefly, what is it you are specifically seeking help for? * What services are you interested in retaining? Compassionate Spirit Guided Healing Energy Hygiene Compassionate Depossession Curse And Thoughtform Unraveling Shamanic Reiki Soul/Power Retrieval Divination/Mediumship Have you had emotional therapy in the past or currently? Please describe. * Have you ever done any of the following: Plant spirit medicines ie: Ayahuasca, Psylicibin, etc., or DMT, Ketamine, LSD or similar therapies? Have you ever had nontraditional healing past or current? Please describe. * Are you currently working with any shamanic practitioners? Please list: * Do you have a spiritual foundation in your life? Please describe. * Do you have boundary or energy hygiene practices in your life? If so, how often do you practice them? Please describe these. Are you currently taking medications? Have you taken significant medications in the past? Please describe? * Have you or are you experiencing any physical symptoms? * Have you experienced any of the following in the last year or so? * Depression or anxiety Recurring negative thought patterns or repeating patterns that I can't change Disturbance, paranormal phenomena or sense of a presence Sense of something missing Significant change after a recent event Thoughts that don't seem to be mine or negative self-talk What would you like to have happening differently in your life? Please describe. * Things to think about: How do you see/sense your life moving forward after a healing session? What would life be like with more clarity, healthy boundaries, more vitality and authenticity? Are you willing to do the discipline of daily energy hygiene practices? * What real supports will you have in place to help insure your integration post session? * I understand Connie is not a therapist or medical provider and this work is not a substitute for therapy or medical treatment. I understand that this work does not intend to diagnose, treat, or cure any disease or mental illness. I understand that this work is not for people experiencing unstable mental health conditions, those who are in crisis, or those with substantive active trauma. I understand that this work can be transformative/cathartic and that I am responsible for acquiring the mental health support, aftercare, or integration work needed to process this work as recommended by Connie or according to my own self-assessment and judgement. * Signature Date Thank you for your time and attention to this important first step!I will review and respond within 72 hours.In Gratitude,Connie