top of page
Home
About Me
Individual Sessions
Ancestral Healing & Family Constellaton
Altars & Ceremonies
Nervous System Reboot & FSM
Energy Clearing & Plant Allies
New Client #1
New Client #2
Book Appointment
Contact
More...
Use tab to navigate through the menu items.
971-285-1858
layakinti@gmail.com
Log In
Client Agreement
First Name/Nombre
Last Name/Apellido
Phone/Telefono
Date of Birth/Fecha de Nacimiento
I affirm I have shared all my medical profile with Catherine and release her of any liability should I fail to do so./ Afirmo que comparti toda mi informacion medica con Catherine y la libero de toda responsabilidad si no lo he hecho.
*
Yes
I agree to communicate with Catherine if at any time my well-being is compromised./ Estoy de acuerdo de comunicarme con Catherine si en algun momento siento que mi bien estar esta compremetido
*
Yes
I understand that this work is to help me connect to my own wisdom and take full responsibility for my choices. Entiendo que ese trabajo me ayuda a conectar con mi sabiduria y tomo toda responsabilidad por mis decisiones.
*
Yes
I agree to pay for each session on that day. I understand that if I don't cancel with at least 36 hours notice, I will be charged for the session. If I arrive more than 15 minutes late, I may lose my session.Me comprometo pagar por cada sesion ese mismo dia. Si no cancelo con mas de 36 horas, entiendo que tengo que pagar por la sesion. Tambien, si llego mas de 15 minutos tarde, pierdo mi sesio
*
Yes
Initials/Iniciales
Today's Date/Fecha de Hoy
I declare that the info I’ve provided is accurate & complete/Declaro que toda esta informacion es cierta, completa y correcta.
Thanks. Gracias
Submit
bottom of page