Health Insights, LLC firstname.lastname@example.org healthinsightsllc.com
John Nicoll Energy Healer Brennan Healing Science Practitioner Intuitive Healer
Please Note: There are 5 forms below for you to fill out and sign. The first four are required and the fifth is optional.
I. Client Information Letter & Consent for Treatment
I am pleased to meet you and to have the opportunity to work with you.Here is some basic information about the healing work in which I am trained and what you may expect during a session.
I am a certified Brennan Healing Science Practitioner. Among the various techniques that I use are healing by laying on of hands and energy work, done both with my hands on the body and also through the Human Energy Field which surrounds the body. I also provide intuitive information to clients. While I may lay my hands on clients as a Brennan Healing Science Practitioner, I do not medically diagnose or prescribe treatment.If you have a physical injury or disease condition, I ask that you be in the care of a licensed medical professional.I do not advise you to discontinue any medical treatment you may be receiving.I may also ask that you be in the care of a qualified psychotherapist.My work is intended to be complementary, that is, to be in harmony with any other healing work that you undertake, including conventional medicine and psychotherapy.Please feel free to discuss our work with your physician, psychotherapist or others on your care team.
It is my experience that the Brennan Healing Science work clears and charges the energy field, removes energetic blocks that lead to disease and enhances the body’s natural healing capability.Many of my clients experience increased well-being and improvement in their condition and life overall; however, I cannot promise you these things.
Healer – Client Services Agreement
This document (the Agreement) contains important information about my professional services and business policies.We can discuss any questions you have about the procedures at the time that you sign this agreement.When you sign this document, it will also represent an agreement between us.By signing this Agreement, you give consent to receive energy healing.You may revoke this Agreement in writing at any time.That revocation will be binding on me unless you have not satisfied any financial obligations you have incurred.
The healing process is not easily described in general statements.It varies depending on the personalities of the healer and client and the particular problems you are experiencing.Healing is an intense, collaborative process in which we will be working through the problems that you hope to address.It is not like a medical doctor visit. Instead, it calls for an active and sustained commitment on your part.
Healing sessions generally comprise two aspects: talking, in which we discuss aspects of your life you are working with, and tablework, when you lie on the massage table, with shoes off, and we work energetically with these same issues.The combination of dialogue and hands-on work offers an excellent combination to support you in working with the issues which brought you to healing.I also may teach you, if appropriate, mind-body practices that you may choose to do on your own.This will enhance and accelerate your process of transformation.
Healing can have benefits and risks.Since healing often involves discussing painful and difficult aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness and helplessness.On the other hand, healing also has many benefits.Healing often leads to better relationships, solutions to specific problems, increased success and significant reductions in feelings of distress.However, I cannot guarantee you ahead of time what the particular outcome will be for you.
Our first few sessions will involve an evaluation of your particular concerns and needs.By the end of the evaluation, I will be able to offer you some first impressions of what our work will include.You should carefully consider this information along with your own opinion of whether you feel comfortable working with me.Energy healing involves a commitment of time, money and energy.If you have questions or concerns about how I can be of use to you, we should discuss them whenever they arise.If your doubts persist, I will be happy to help you set up a meeting with another healer for a second opinion.
Self-care is an extremely important part of your healing process.At all times your healing is your responsibility.If at any time during the session you are uncomfortable, it is your responsibility to inform me immediately.I also recommend that you refrain from using alcoholic beverages for 24 hours following your session.
My approach to healing and personal transformation is holistic, focusing on you as a unique, complex dynamic being of body, mind and spirit.I offer to serve as a facilitator in your self-initiated process of healing and transformation.I am here as your committed listener, your mirror, your partner in the process.In the course of our work together, we will explore areas that influence your state of well-being.We may address your health history, life stressors, belief systems and attitudes, your family and childhood history, diet, exercise, dreams, longings, and how you are in relationships.Your sharing is always kept confidential.I do, however, discuss clients, without mentioning their names, with my professional supervisors or professional peers for the purpose of my continuing professional development and so that you, as client, may receive the best care possible.
Sessions & Cancellation Policy
I normally conduct an assessment process that will last from 1 to 2 sessions.During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals.In order for healing to be most successful, it is important that you prioritize the time set aside for healing and that you make every effort to keep your appointments.Once an appointment hour is scheduled, you will be expected to pay for it unless you provide a minimum of 48 hours advance notice of cancellation.I will make an effort to fill your hour in case of a cancellation.If I can fill your appointment time, you will not be charged.
Due to my work schedule, I am often not immediately available by telephone.I do not answer the phone when I am with a client.When I am unavailable, my telephone is answered by voicemail which I monitor between 1:30pm and 6pm Mountain Standard Time.I will make every effort to return your call as soon as possible.If you are difficult to reach, please inform me of some times when you will be available.If I am unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary.
We may prefer to set up a regular schedule to work but there is never any obligation to continue treatment. We can discuss ways to continue ongoing work at our first session.
Should you have any questions about any part of the above, please feel free to ask.
YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READTHIS AGREEMENTAND AGREE TO ITS TERMS
II. Client Agreement
III. Acknowledgment & Consent for Treatment
IV. Confidential Health Inventory
Please complete one of the two forms below. Both are confidential.
If you are seeing me regarding Accutane/RoAccutane/Isotretinoin recovery, please click on the button below to fill out the Confidential Accutane Intake form instead of the Confidential Health Inventory.
This form is optional and can be submitted multiple times if needed.
At times, you may request that I share information about your healings with other members of your healthcare team. Or I may ask you if you would like me to share information with other practitioners.If you are willing for me to do this, please sign the Consent to Release Information form below.Keep one copy for yourself and I will keep a copy in your file.Please complete a separate form for each practitioner with whom I will be sharing information.