Client Intake Form

Healing Session

Thank you for choosing to have a Healing Session with Colleáyn Klaibourne.
* Each family member needs to fill out a separate intake form.
These sessions are done via Email.
Information to send to Colleáyn at least 48 hours before your session: 
  1. This Client Intake Form. * All fields are required.
  2. Photograph(s): Email or send Colleayn a clear, recent photograph(s) (within a year or so) with at least one with your eyes facing towards the camera. This is how I tune into you.
  3. Payment. Pay via website or Colleayn can email you a PayPal invoice. If you are a return clients and prefer to send a check before the session, email Colleayn for the address.

I look forward to working with you.

Client Intake Form

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The reason I ask for occupation is in case I'm seeing different work, hobbies, education, etc. that would be good for you to explore.
What are your goals or what do you hope to receive from your healing session?
For individuals who are having healing sessions before, during and after surgery.

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Birth Information for Astrology Chart. *Required for Zoom Healing Sessions*

Please include your birth location, exact time of birth and if you were born in the am or pm.
Please write out the month. For example: January 1, 1999 or March 2, 2011.
Exact birth time is required in order to create an accurate astrology chart.
Ex. Birth Certificate (Hospital Record, Birth Record), Parental Memory, Baby book, Rectification from another Astrologer....

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Thank you.

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