Please take a few careful moments to sit quietly and to fill out the form below to the best of your knowledge and fill out based how you are feeling before your Healing Touch session with Amy. She will review and ask questions the day of your session.
This form needs to be filled out in full at one time as the system will “time out” if you walk away. So please be alert to your timing when filling out.
Dress comfortably for your session, you will take your shoes off and lay on a treatment table. I do have a blanket to cover you if the room is too cold for you.
I look forward to working with you and happy to answer any questions that come up - email me at ScottsdaleHT@gmail.com or call 480-712-3685
Thanks for filling out your Intake Form and providing Consent to work with you on your healing journey.
You have received information regarding Healing Touch from Amy Stephens and you understand that Healing Touch is a gentle, complementary energy based approach to health and healing that can assist your body in its natural ability to heal. You fully acknowledge and understand that this is accomplished through the use of contact and/or non-contact touch. It has been explained to you, that Healing Touch is a complementary therapy not intended to replace any currently prescribed medical treatments as ordered by your physician nor any other medical practitioner.
Sessions are not meant for diagnosing or treating any physical or mental disease or condition. Healing Touch services do not substitute for diagnosis and treatment from a licensed health care practitioner for illness or injury or other medical conditions. Always speak with your medical practitioner directly about concerns of your health and well-being.
All client information and records provided during a Healing Touch Session will be kept confidential. Information may not be released to individuals or agencies without your signed authorization. Practitioners are required by law to report the threat of serious harm to self or others. Client files are maintained in strict confidence, and locked in a secure space.
Healing Touch is used for any of the following:
Reduction in pain, anxiety and stress
Decrease in nausea, vertigo and headaches
Preparation for medical treatment and surgeries to manage side-effects
Support during chemotherapy
Supports the body's natural healing process and sense of well-being
Facilitation of wound healing
Emotional, Mental and Spiritual support