top of page

START YOUR WELLNESS JOURNEY WITH US

Client Intake Form

General Client Information

Multi-line address
Preferred Contact Method
Email
Text Message**

Select the method you would prefer One Rising use for contacting you

(This will be used for communications including but not limited to; general discussion, follow-ups, appointment reminders, etc.)

** = Data Rates May Apply

Birthdate
Month
Day
Year
Gender Identity

DEFINITIONS AND LEGAL INFORMATION

Definition of Quantum Spiritual Healing/Coaching 

Quantum Spiritual Healing/Coaching is guiding another person through their spirituality, and using this spiritual perspective to deal with life issues in a positive and constructive way. Spirituality believes in a source greater than yourself, called by whatever name you feel comfortable. When a person feels disconnected from their spiritual self, Quantum Spiritual healing/coaching helps build a bridge between the separated self and the Divine Self. 

Goal of Quantum Spiritual Healing/Coaching 

The Quantum Spiritual Healing/Coaching provides and maintains a safe space for open sharing, communication, and energy work.  The Coach will remain open, receptive, compassionate, non-judgemental, and support each client in their individual spiritual journey to support their enlightenment, growth and overall reconnection with themselves in the spiritual realm.

Confidentiality Policy Related to Quantum Spiritual Healing/Coaching 

All information discussed in each session is completely confidential with three exceptions:  (1) when a client poses a danger to themselves or others (2) when requested by a court of law  (3) for purposes of professional supervision (in which case, no identifiable information will be released) (4) or for the purposes of completing a more holistic spiritual treatment program working with other members of the spiritual community (in which case, permission will be acquired prior to release)

Definitions & Legal Information
bottom of page