Book a Consultation

These sessions are not an attempt to practice medicine or provide specific medical advice, and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Clients should not rely upon these sessions for emergency medical treatment. The content in these sessions and any additional materials are not intended to be a substitute for professional medical advice, diagnosis or treatment.
Completion of this form does not guarantee a session. I reserve the right to refuse service to any potential client and may choose to refer applicants outwardly to another practitioner if applicable.

Name

First Name

Last Name

Pronouns

Message

How old are you?

Client must be 18 years or older to book a session.*

Briefly describe your current state of health. What symptoms stand out in particular?

Is there any additional information you would like to provide?