Client Intake & Consent Form

The purpose of this consent is to be clear with you on what I do and what you may expect regarding the healing session. I work with your energy field and your chakras through various techniques characterized by one or more of the following; by placing my hands on or around your body, through dialogue, guided imagery, silently working with your chakras and energy field, and soul work. I believe that we all have the ability to heal ourselves. I act as the facilitator for the healing through prayer, ‘listening’ to your body and serving as a conduit of Universal healing light and love. By connecting with you and working with the energy, I will help you release energetic blocks and assist you in reconnecting to your own internal self-healing ability and soul’s purpose.

I may ask you questions about your family history, challenges in your life, childhood, or other issues that maybe affecting your present state of health. In addition, I may share with you the impressions that I receive. We might also work in silence. If you have a preference, please let me know. All of what we discuss will be kept confidential unless you and I decide otherwise.

It is my intention to work in harmony with any other medical or healing treatments you may be having. I do not advise discontinuing any medical treatment you may be receiving at this time. I believe that we, as individuals, are always responsible for our own health and healing.

While an individual session can be powerful and healing on it’s own, I prefer setting up a regular schedule to work with you if personal growth and healing is your intention. Neither one of us is under any obligation to continue if it is not advantageous. 12 hours’s notice is required if you need to cancel or reschedule you appointment. Appointments canceled without the required notice will be responsible for the full fee.

In submitting this form, I hereby acknowledge that I have read the above statement and agree to this type of healing work. I release Michelle Porter from any and all claims of malpractice, non-disclosure, confidentiality, or lack of informed consent. I freely assume any and all risk of the treatment whether presently contemplated or hereinafter discovered.