It's Time For Healing Intake Form

All information received on this form will be treated as strictly confidential. Please fill out the form completely and accurately. This information is essential to helping the therapist safely and effectively, develop your personalized wellness program; I understand my Practitioner does not diagnose any medical, physical or mental disorder or prescribe medication. This service is not intended to diagnose, treat, cure or prevent any disease. Those seeking treatment for a specific disease should consult a qualified medical, integrative or holistic physician, prior to using our service. The statements and services offered have not been evaluated by the U.S. Food and Drug Administration. www.itstimeforhealing.com
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    GENERAL

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