Portal Intake | S O L A R I
This form opens the channel between us. Please complete with presence, honesty, and intention so your session may be attuned to your soul's highest readiness.
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How did you find S O L A R I ? *
Please enter the full name of referring client/provider.
Are you currently taking any medications or supplements?
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Are you under the care of any physician, therapist, or provider? *
If yes, please share anything relevant you'd like for S O L A R I to know.
Have you received energy healing before? *
Choose your entry point. Each session is an initiation into deeper healing, clarity, or remembrance. Please select the first step that most resonates with your current needs. All sessions are held at SOLGATE in Sugar Land, TX or virtually. If your path isn’t listed, select “Other” and describe what you’re seeking. We will respond to discuss aligned options. *
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Do you prefer in-person at S O L G A T E (Sugar Land, TX - details will be provided at confirmation) or virtual? *
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What called you to this work with S O L A R I at this time? List any specific emotional, physical, or spiritual focus you'd like to explore. *
Do you have any sensitivities to the following? *
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Shiloh, an Emotional Support Animal (ESA), is available for add-on in the marketplace and is occasionally in the chamber for in-person sessions. Do you need an allergy free session (special arrangements will be made to guarantee this accommodation)? *
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Optional CBD Enhancement: I consent to the optional use of legal hemp-derived CBD topical products for wellness support during my session. *
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CONSENT + AGREEMENT: Open Gate Wellness, LLC  Liability Waiver. I understand that the services I am receiving are rooted in energy healing, spiritual guidance, and frequency recalibration. These are not substitutes for medical or psychological treatment. I enter into this process with openness, full agency, and sacred consent. I understand that S O L A R I offers this work under Open Gate Wellness, LLC, and I take full responsibility for my healing journey. I am responsible for my own health and should consult licensed medical professionals for medical concerns. THE OPEN BODY PRACTICE: I acknowledge that I have chosen to receive assisted somatic release and bodywork services from Open Gate Wellness, LLC (which herein shall include all of its owners, members, practitioners, facilitators, officers, affiliates, and employees). I understand that the services offered involve physical touch and guided body movement, and that while every precaution is taken to ensure safety and comfort, these sessions may involve physical exertion and emotional release that could carry inherent risks. I recognize and understand that while unlikely, my participation may result in temporary discomfort, fatigue, or emotional sensitivity. In rare cases, participation could result in physical injury (including without limitation muscular strain, nerve discomfort, or skeletal stress). I assume full responsibility for my participation and agree to communicate any pain, discomfort, or concerns immediately during the session. CBD TOPICAL USE CONSENT: I consent to the optional use of CBD-infused topical products during my session. COMMUNICATION CONSENT: By signing this form you agree to receive emails from Solari. You can opt out at anytime. HEALTH ACKNOWLEDGEMENT: I hereby affirm that I have disclosed any medical or physical conditions that may affect my participation. I warrant that I have no known medical conditions that would put me at increased risk of injury as a result of receiving assisted somatic release services. I further acknowledge that Open Gate Wellness, LLC and its practitioners are not medical doctors and do not diagnose, treat, or prescribe. These services are complementary and do not replace medical care or therapy. RELEASE OF LIABILITY: In consideration of the above risks and in accepting the services offered by Open Gate Wellness, LLC, I voluntarily waive, release, discharge, and hold harmless Open Gate Wellness, LLC, its owners, affiliates, practitioners, and employees from any and all liability, claims, demands, or actions arising from or related to my participation in assisted somatic release sessions of  The Open Body Practice. This includes any claims resulting from negligence or acts of omission. I fully understand that by signing this document, I am waiving certain legal rights, including the right to pursue legal action against Open Gate Wellness, LLC for any injury, loss, or damage sustained as a result of participation in these services. This agreement shall remain in full effect for all future sessions unless revoked in writing. I have read and fully understand this agreement. By signing below, I acknowledge and accept all terms voluntarily and of my own free will. *
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SCHEDULING: To honor your time and mine, you will be contacted to schedule within 24 hours once payment is received. Please list your desired days/times below and the best will be done to accommodate you. *
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Typing your full name below serves as your legally binding electronic signature. *
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