Forms + DOCUMENTS
Required forms, important documents and general information for clients including informed consent and initial intake, what to expect, consumer rights and practitioner responsibilities, codes of ethics, scope of practice, safety precautions, authorization for release of information, feedback submission, terms & conditions, illness protocols, and more.
Informed Consent
New Clients
Please print and complete this form and bring it with you to your first appointment. Remote Session Clients may use the online form, mail, or scan and email the print form. I must receive it before by or at your first session. Minors under 18 years of age must have a parent or legal guardian sign this form before Intake or treatment can begin.
Initial Intake
Intuitive Healing Sessions
NEW CLIENTS scheduled for a Foundational Session: please print and complete this form and bring it with you to your first appointment. Remote clients may mail or scan-and-email your form to me before your appointment (e-mail is not HIPAA compliant. E-mail at your discretion). The mailing address is provided in your appointment confirmation e-mail. If you prefer, we can complete the form together during your initial session (no printing necessary).
Vibrational Essence + Remedy Consultations
NEW CLIENTS scheduled for a Foundational Session: please print and complete this form and bring it with you to your first appointment. Remote clients may mail or scan-and-email your form to me before your appointment (e-mail is not HIPAA compliant. E-mail at your discretion). The mailing address is provided in your appointment confirmation e-mail. If you prefer, we can complete the form together during your initial session (no printing necessary).
Documents
What to Expect During Your Session, California Senate Bill-577 (CA SB-577) regarding your rights as a consumer of complementary health care, my compliance with the requirements laid out by CA SB-577, and BioMat® Safety Precautions for BioMat® Clients. Also included are the Healing Touch Program's Code of Ethics, Policy and Procedures, and Scope of Practice documents, and the International Association of Reiki Professionals Code of Ethics. I believe it is important to be informed about the healthcare we choose and offer these documents to support you to this end.
Terms & Conditions
Terms & Conditions including those for individual Intuitive Healing Sessions, Healing Touch, Reiki; Vibrational Essence and Flower Remedy consultation, formulation and treatment; packages, gift certificates and workshops, payment, cancellation and rescheduling policies.
Feedback
Your feedback helps me better serve you and others. I invite you to share your thoughts and experiences with me. If you are interested in providing a testimonial to help others better understand the work that I do this form contains an optional release for that purpose. I am interested in reading what you share and thank you for your willingness to help me grow.
Authorization for
Release of Records
Required if you wish me to share information about our work together with others, including members of your healthcare team. Without this form I am unable to discuss or disclose your protected health information with anyone, except where specifically permitted or required by law. This authorization does not grant other providers permission to share your information with me, is revokable and entirely voluntary.
COVID-19 Safety & Illness Protocols
COVID-19 safety precaution and protocols including client responsibilities, office practices, and the personal precautions Natalia takes to keep clients, herself, her family and the community safe. Applicable to all In-Studio sessions and consultations, depending on community infection levels.
Dia de los Muertos
Guide & Resources
Printable guides intended to help you create or deepen your personal remembering practice through ancestor altar/shrine creation. This guide is non-denominational and not Dia de los Muertos specific. Also available here is as a Dia de los Muertos informational resource list. Online guide and resource list available in Free Online Learning section of the Learn tab at the top of this page.