Mystic Jade Healing
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New Patient
​Intake Form

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    Please mark the circle that best describes the level of stress for the below listings.








    I understand that the above information will be kept in strict confidence and is provided to Michelle Ketcham of Mystic Jade Healing in order to receive the best possible care and service.  I understand that the service Mystic Jade Healing provides is intended to enhance relaxation, increase communication within the areas of the body, and to educate me to possible energetic or emotional blocks that may create pain and disease.  The sessions are non-invasive, safe, and objective.  It utilizes the body's own innate intelligence to reestablish communication within itself. 

    I understand that the sessions Michelle of Mystic Jade Healing gives are not a substitute for medical treatment or medications.  I am aware that Michelle does not diagnose illness or disease nor does Michelle prescribe medications. 

    Late Arrivals: your session may need to be shortened to accommodate other clients who have made appointments.  You will be charged for a full session.

    Thank you so much for selecting me as your Practitioner.  I look forward to meeting and working with you.
    Michelle Ketcham, Certified BodyTalk Practitioner, Reiki Master, and BodyIntuitive Pracitioner
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 Coeur d 'Alene, ID 83815
                                        


Home
About Me
Services
Resources
Blog
Contact​
  • Home
  • About Me
  • Services
  • Resources
    • Cortices Technique
    • BodyTalk System
    • BodyIntuitive
    • Tuning Fork Therapy
    • Reiki
    • What is Muscle Checking?
  • Blog
  • Forms
  • Contact