Energy Healing Questionnaire

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Energy Healing Questionnaire

Please make sure to complete all fields.

Do you have any physical pain? If yes, rate the level, 1 being the lowest 10 being the worst, if no choose 0.

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Do you have any emotional pain? If yes, rate it, 1 being the lowest and 10 being the worst, if no choose 0.

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Evening sessions are available upon request!

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