Heal Artfully/Certified Organic Woman New Client Questionnaire (adult)

Undoing autism in my own home required a holistic all-encompassing approach to natural healing as well as a complete paradigm shift in my methods of thinking and problem solving. As a result, I discovered that disease is merely a manifestation of toxicity. I work best with clients when they begin to understand the need for whole self healing which includes, physical, mental, emotional and spiritual cleansing and rebuilding. Illness can unravel, and it does so in layers. All of my services represent the collective system that has proven successful in my home, and with my clients. Please be advised that I do not claim to be a doctor or have medical answers.I only claim to be a woman and mom who has found my own answers through research, formal study and experience.

I am a Certified Reiki Practitioner and have studied Autism and Digestive Recovery with Donna Gates (author of Body Ecology).

By filling out this form, you enable me to understand your unique concerns and address your situation in a more personal way. I value your comfort and privacy, and will never share your personal information. Please be as specific as possible when answering, and only share details that you feel comfortable sharing.

Please skip questions that don't apply to you.

Review my service model here: http://docs.google.com/Presentation?id=dc99z8dw_27htkhd8f4

Prices:
$80/1 hour session
This includes:

* your preferred combination of coaching services/healing
* My intuitive interpretation and messages received through my own private meditation on your case
* Feedback from you and answers to your questions
* A follow-up email which will cover all that we discussed

I accept cash, check and Paypal payments. (Paypal is a secure way to pay with credit card or debit card without sharing your personal information or card numbers. You can easily sign up for Paypal free here: http://www.paypal.com )

Other options are available for those with financial hardships (make sure to check the proper box below)

Payment must be received before your consult or at the time of your consult ( if meeting in person). Checks will not be cashed until after consult.

Please email me at gina@healartfully.com with questions. I am happy to help you!

Gina

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