Spiritual Warrior Woman

Trauma Touch Therapy Intake Form

Please complete the form below after booking your appointment. Our system is safe and secure. Your privacy is of the utmost importance. For more information, visit our privacy policy.

May a message be left?
Abuse History (Mark al that apply)
Degree of Abuse (Choose one)

FOR YOUR INFORMATION:
As a Trauma Touch Therapist, I am not qualified to make any diagnosis or prescribe any treatments. All recommendations are to be viewed as suggestions. All sessions are confidential. Please see my Notice of Privacy Practices. All sessions are strictly non-sexual in nature. Client remains fully clothed during sessions.
 

CLIENT RESPONSIBILITY AGREEMENT:
I agree that I am responsible for my well-being while participating in TTT (TRAUMA TOUCH THERAPY).

 

I agree to be responsible for my participation in, and creation of, this therapy.
 

I agree to take responsibility for my truth, my feelings and needs, and whatever issues arise for
me, and ask for support when necessary.

 

I am willing to have learning transformation happen in ways that are totally loving and kind to me and everyone else.

Thanks for submitting!