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Please fill this Pranic Healing Intake Form ONLY IF you've booked sessions for someone else.
Is the client a minor (under the legal age as defined by the laws of their state or country of residence)?
Yes
No
Please state your relationship with the client.
*
Will you be actively involved with Lifeforce Integrated on behalf of the client (providing updates and feedback, scheduling Touch Base meetings, etc.)?
*
Yes
No
Your Phone Number: (If you're actively involved with Lifeforce Integrated you may be added to a WhatsApp group exclusively dedicated to the Pranic Healing package.)
*
Your email: (This must match the one in your member profile to receive emails from us. You may log in and update it in the My Account section.)
*
Please state your full name
*
Your country of residence
*
Do you live with the client?
Yes
No
If you don't live with the client, are you able to visit or communicate with them? How often? Please elaborate.
*
Is the client willing to receive Pranic Healing energy therapy?
*
Yes
No
Other
If you selected 'Other', please elaborate.
*
Will you be the client's emergency contact?
Yes
No
Please click Next to start filling in the Client Details form.
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