Forms + DOCUMENTS
Required forms, important documents and general information for clients including informed consent and initial intake, 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.
No forms necessary for Free Exploratory Consultations.
Informed Consent
New Clients
Free Exploratory Consultations excepted: Please print and complete this form and bring it with you to your first full length appointment. Remote Session Clients may return the form by mail or scan and email it. 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
New Clients
Intuitive Healing Sessions
New clients scheduled for a Foundational Healing 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).
New Clients
Standard Vibrational Essence + Remedy Consultations
New clients scheduled for a Foundational Remedy 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).
New Clients
Case Study: Vibrational Remedy Foundational Consultations
Case study participants scheduled for a Foundational Remedy 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).
Terms & Conditions
All Clients
Free Exploratory Consultations excepted: Terms & Conditions including those for healing sessions; vibrational essence and flower remedy consultation, formulation and treatment; packages, gift certificates and workshops, payment, cancellation and rescheduling policies.
Illness Policy & Responsibilities
All Clients
Free Exploratory Consultations excepted: Illness safety precautions 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.
Documents
For Your Information & Records
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.
Testimonials & Feedback
Share Your Feedback or Story
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
Share Your Confidential Records with Your Other Providers
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.
Dia de los Muertos
Free Guides & 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.