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Be Free with Kat -New Client Intake Form
Please submit this form, completed, no later than 24hrs prior to your session time. Thank you!
Name *
Date of Session with Kat *
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Please provide your email address for correspondence purposes. I will be including your email in my newsletter and offerings (I don't spam constantly, maybe once a month or so), and if you wish not to receive further emails, you may unsubscribe at any time. *
Phone number
How did you hear about Be Free with Kat? Check all that apply ;) *
Required
Are you under any current medical care (prescriptions, recent surgery, or treatments) *
Please share with me your areas of discomfort (include physical, emotional, mental and/or spiritual) *
For the next 4 questions please rate on a scale of 1-10, (10 being the highest/best) level of your current Physical Health *
Worst
Best
Rate on a scale of 1-10, (10 being the highest/best) level of your current Emotional Health *
Worst
Best
Rate on a scale of 1-10, (10 being the highest/best) level of your current Mental Health *
Worst
Best
Rate on a scale of 1-10, (10 being the highest/best) level of your current Spiritual Health *
Worst
Best
On which side do you feel, if any, physical discomfort on? 
Clear selection
Please rate on a scale of 1-10, (10 being the most) level of your experience/exposure/openness to: Energy Treatments (Reiki/Quantum Touch/Intuitive Readings, etc.) *
Little to None
A lot
Please rate on a scale of 1-10, (10 being the most) level of your experience/exposure/openness to: Law of Attraction teachings/practice. *
Little to None
A Lot
How strong is your awareness to the Divine (Higher Self/God/Goddess/Spirit/Universe or whatever you would consider to be a higher creative power)? *
Little to None
Very Aware
What would the top two most 'freeing' things that you would like to create/experience, be? *
How my energy treatments work: 
I always connect to my client's Highest Good and have this as my focus when I facilitate a Be Free session for them. This session is comprised of this completed intake form, (which I intuitively review prior to our meeting) Law of Attraction coaching, Master Reiki/Light Energy treatment & intuitive readings.

I allow my physical & spiritual bodies to be a vessel for a large amount of Master Reiki energy (and higher realms) to be channeled from my Reiki Guides and the Healing Angels. This Divine energy flows to the client and balances their aura, chakras, and any other areas (emotional, physical, mental and/or spiritual) that align for their Highest Good. 

It would be beneficial if the client were to consciously open themselves up to receiving this energy for maxim benefit.  

Sometimes my clients experience emotional release, physical comfort (or discomfort depending on what is necessary for change), elation, hope, surrender, and/or deep relaxation. Sometimes they may experience seeing colours (eyes closed), feeling hot and/or cold  or other physical sensations. Sometimes they receive visions from the past, but from a behind the scenes experience.

As an energy treatment, the effects from this session may last several hours or days. *Please indicate your acknowledgment of this explanation of the energy treatment part of the session.
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Release of Liability. Your typed response, and submission of this form indicates your agreement to the following: Having read the above section on what a Be Free with Kat session is, I understand that I am hiring Katrina (Kat) Crozier to work with me utilizing her training and experience in various alternative health modalities, and to guide me on how to experience the life I wish to live. 
I accept that she is not diagnosing me under Western medicine practices, nor is she prescribing any form of medical treatment. I accept full responsibility for my own health. I release her and any location she hosts my session in, from any perceived liability associated from the session. I accept that I create my comfort AND discomfort. **Please date and type your full legal name.
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