Quick Check-In Session Form

You must fill out this form and upload your photo before I can complete the quick session.

(I will email you the results within one week.)

Please complete the form below:

Name

First Name

Last Name

What would you like me to work on in this quick session?

Enter the physical or emotional symptom you would like me to work on, and what sort of help you would like (ie beneficial supplements, emotion clearing, etc)