Mindful. Artful. Personal.

Distance Energy Healing form

Thank you for your interest in distance energy healing.

Distance energy healing means that we do not connect in-person, but rather energetically. You, as the client, may relax in your own space and receive healing and support from afar.

To begin this process, please complete and submit the form below. Once I receive and review the form, I will confirm session details with you via text or email.

In Support + Connection,
Sara

Name

First Name

Last Name

Preferred Name/Nickname and Pronoun

Email Address

Phone Number

Address

Preferred mode of communication (Text or Email)?

How did you find your way to me and Cellular Expansion & Healing?

What are your desired outcomes or intentions for distance energy healing session(s)? Please share as much as you'd like about the areas of your life that you are wanting to change and heal.

When did the circumstances you described above begin?

Do you have experience with distance energy healing? If yes, please briefly describe.

Please choose a date you would prefer to begin your distance healing. Please note, sessions are available on Wednesdays and Thursdays MST.

YYYY

What times would be best for you to receive distance energy healing? Please include your location and time zone.

Distance sessions last 45 - 60 min each and cost $60 per session or $160 for a 3 session bundle. Payment is via Venmo or Zelle. Does this arrangement work for you? Please respond yes or no and include whether you prefer Venmo or Zelle, as well as if you would like to start with one session or the three session bundle. Thank you.

Please note, energy healing is not a replacement or substitute for any medical care or advice and does not have guaranteed outcomes. Energy healing is meant to complement or be an addition to your medical care.

I acknowledge that energy healing does not replace medical care and does not guarantee any specific results or outcomes.

I do not acknowledge this. Please note, if you choose not to acknowledge these statements, we will not schedule sessions. We have your best health and interests in mind and thank you for your understanding.

Anything else you'd like to share or ask?