Important Notice: The health and safety of my clients and myself are of upmost importance. Respectfully, due to COVID-19 Coronavirus, all face to face healing services have been temporarily suspended until further notice. Intuitive Reiki, Energy Readings, Light Coaching and Past Life Regressions will still be available as a Distance session at a slightly discounted rate. Thank you for your understanding of this very pertinent matter. All distance appointments are considered Eastern Standard Time Zone. You may have to adjust your appointment time accordingly.

Past Life Regression Appointment Release

Past Life Regression Therapy uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of awareness - to explore what is stored in the subconscious mind. During therapy, you are completely aware and conscious however the thinking mind becomes extremely relaxed allowing the subconscious to step forward.

Service time is 2 plus hours.

Name

First Name

Last Name

Date of Birth

Phone

(###)

###

####

Emergency Contact

Occupation

Children

If yes, names and ages

Parent's Names

Siblings

What do you hope to come away with today?

Have you every experienced hypnotherapy?

Do you meditate, do yoga or practice any kind of inner quiet or mindfulness techniques?

Do you have any spiritual or religious beliefs?

I understand that a past life regression is not to be used in place of any medical or psychological treatment or therapy. I also agree that there is no guarantee of what or how I experience this past life exploration service. I agree that the Past Life Exporation Therapist is not responsible for art side effects or outcomes. All fees are due at time of scheduling said service and there are no refunds on services rendered.

Yes, I agree with the terms stated above.

No, I do not agree with the terms stated above.

PLR Release Form

Past Life Regression Appointment Release