Client Intake Form

CLIENT INTAKE FORM

We appreciate you taking the time to review this information, complete the enclosed form, and supply us with the items requested below.

Please complete this participant/client  Assessment form before your appointment and send it back at least 5 days in advance to (email).

If the form is received on the day of our meeting, we may need to review it, which takes time away from your healing session.                                                           

Your sessions will include a quick introduction before we start and a wrap-up afterward. 

CANCELLATION POLICY

If you need to reschedule or cancel your appointment, please notify us at least 48 hours in advance to avoid a cancellation fee. Any sessions canceled within 24 hours will incur the full session fee.

INFORMED CONSENT FORM

The United States of America has no licensing policy regarding Sound or Energy Healing, and Raven Runyan is not a licensed Medical Doctor or therapist. I do not deal with drugs, nor do I issue a diagnosis or suggest cures.

I aim to provide a safe space for my client to experience healing through natural processes. I consider using sound, energy, herbs, essential oils, crystals, and any other natural healing modality to encourage the body to get back to optimal functioning, and everyone reacts to these methods individually. I make no claims for their medicinal actions nor cite scientific evidence. Any information offered is based on personal experience and traditional uses.

My clients agree to make their own choices regarding what they do with the educational material they have been offered and are solely responsible for their own decisions and actions. It is always my recommendation to seek out the advice of a licensed healthcare professional whenever they feel it is necessary regarding their health, especially with serious conditions. Clients need to consult with their physician and get approval to attend healing sessions if they have metal in their bodies, have suffered concussions, have a pacemaker, use an insulin pump, and the like. If in doubt, please consult your physician before our time together.

Some issues, such as suicidal thoughts or life-threatening illnesses, are beyond the scope of my expertise, and I would advise you to seek outside help.

I understand that:

• An assessment will be conducted to determine the general health of my energy system
• Any suggestion made by Raven Runyan will be to assist my body's natural ability to achieve a balanced state to the extent that my body or my highest knowledge will allow
• The goal of my session will be identified as part of the initial process, and I will have input and give intent and permission for it.
• These sessions cannot replace treatment by established medical practices but complement them.
• There are no guarantees as to the results of treatment
• Raven Runyan is not a licensed physician and will neither diagnose nor prescribe any condition nor make any specific claims regarding the results from the sessions I received. Nothing in the work Raven does is considered the practice of medicine.

I agree to:

• Raise any questions or concerns about anything I do not understand.
• Consider any suggestions Raven may raise concerning referrals to other health care practitioners, homework, or my desired focus/introspection.
• I take full responsibility for my health care.
• Give consent to Raven to conduct a session to balance my energy system. I acknowledge that this could involve touch, and I can request otherwise.

WHAT TO EXPECT

Generally, a typical session begins with a short assessment to discuss your concerns, thoughts, or questions. During the session, you can choose to sit or lie down. While we try to make you as comfortable as possible, please bring your pillow or blanket if you have specific needs. We make every effort to ensure that our clients feel safe and comfortable.

We may work on your body or above your body, so please let us know if there are any areas that you do not want work done. If you do not wish to be touched, please let us know.

Our work is intuitive, so we feel the energy and work where the power is stagnant, deficient, stuck, or unbalanced. You may feel many different results, such as heat or cold, shivers, nausea, headache, relaxation, release, relief, etc. You may also feel nothing at all. Any reactions can happen immediately or even months later. No response is positive or negative; it purely is. It may mean something to you immediately or be a mystery for a while. Both are normal. We find that energy medicine has a cumulative effect, so when you treat yourself to regular sessions, better health and well-being are natural outcomes. At the end, we will check in about anything that came up for you during the session.

I have read the above statements, and I understand and agree with them. My purpose in seeking Raven's advice is for educational purposes only.

Raven Runyan does not diagnose illness, disease, or mental disorder. Nor does she prescribe medical treatment or pharmaceuticals. It has been made clear that my session is not a substitute for medical examination or diagnosis and that it is recommended that I see a medical doctor for any physical or mental ailment.

I agree that Raven Runyan cannot be held liable for any problems that might arise that could be attributed to the energy healing season. I have stated all of my known medical conditions to Raven, and if necessary, I will keep her updated on my physical, mental, and emotional health. I acknowledge that Raven Runyan can provide mental/emotional/physical, and spiritual support through multiple techniques. I attest that I understand the nature of the session and freely elect to receive the techniques. I release Raven Runyan from malpractice claims, non-disclosure, or lack of informed consent.

NOTE: If you checked any boxes above, please contact your physician and get approval for using plants & Herbs in our work! If we cannot use plant medicine, there are other modalities that we can use.  My goal is to keep you healthy and safe.

NOTE: If you checked any boxes above, please contact your physician and get approval for sound therapy before we begin our work! If we cannot use sound therapy, there are other modalities that we can use.  My goal is to keep you healthy and safe.

Put an X next to each statement that corresponds to the way you often feel.