Energy Garden Application

Thank you for your interest in an Energy Garden Session! You must be 18+ to book a session with me.

During an energy work session, I may place my hands on your body unless you request a hands-off technique. You might feel a floating sensation, emotional release, increased relaxation, enhanced sense of balance, centeredness, and calm.

You could potentially also feel discomfort. Every body is different and I will make no promises about what you might feel or what might come up but hope to provide a safe-enough container to be present with any feelings that may arrive.

Virtual sessions may include a combination of breathwork and self-touch.

Name

First Name

Last Name

Phone

(###)

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Pronouns

examples: he/him, she/her, they/them

What type of session?

What are you seeking support with? What are the main things you'd like to work with during our time together?

What comes to mind when you think of a peaceful place? For example, somewhere in nature, near water, a mountain, what is your element?

What are your current greatest challenges or obstacles when it comes to meeting your goals?

What is your previous experience with therapy/coaching/personal development/breathwork/hyposis?

What symbolizes the highest good to you?

Are there any injuries, surgeries, or recent health conditions that you feel the need to share?

Are you sensitive to any perfumes, essential oils, or fragrances?

any known allergies or known aversion to any specific plants or oils?

Do you have any additional comments or questions before we begin our session?

I will not diagnose conditions, prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. This work does not take the place of medical care. It is recommended that I see a licensed physician or licensed health care professional for any physical or psychological ailment I may have. Having read, completed and understood the foregoing, I request to receive Pleasure Ceremony's services. I understand that my practitioner is providing their time for me at my request, and is not responsible for the outcome of the session. I agree to hold the practitioner harmless for any intended or unintended result.

I agree

If you reschedule your appointment 24 hours or more beforehand, your deposit can be transferred to a future session. If you reschedule or cancel less than 24 hours before your appointment, your deposit may be forfeitted.

I agree

Having read, completed and understood the foregoing, I request to receive Pleasure Ceremony's services. I understand that my practitioner is providing their time for me at my request, and is not responsible for the outcome of the session. I agree to hold the practitioner harmless for any intended or unintended result.

I agree