Confirm Day and Time (Pacific Time)
Are you currently under a doctor's care for any condition?
What kind of treatment or therapy (briefly)?
Are you open to exploring the Mental, Emotional and/or Spiritual aspects of healing?
Are you willing to spend some time doing Qigong prescription exercises?
*What would you like to get out of your session?
Is there anything else that you feel it is important for your therapist to know?
How did you find out about the clinic?
* I understand that the person who I will be working with is not a Medical Doctor and does not medically diagnose, treat or prescribe. I understand that this is a Medical Qigong student clinic that I am volunteering for and that information about this session might be shared anonymously as part of the student's learning experience.