In Person Session Intake

Intro text:

Before You Begin

Please take a few moments to complete the questions below thoughtfully. These questions help us understand whether this setting and style of care are a good match at this time.

There are no right or wrong answers.

Thank you for taking the time to complete this intake.

These questions help us understand whether this style of care and this setting are a good match for you at this time.

There are no right or wrong answers. Please respond honestly and thoughtfully.

First name

Last name

Phone

Yes, subscribe me to your newsletter.

Short answer

How have you Come to know Casaroma Wellness ?

Classes, products, online learning, previous sessions, or another connection.

What has drawn you to consider an in-person session at this time?

What kind of support are you hoping to receive through a session?

Are you currently working with other practitioners or receiving other forms of care?

This can include medical, therapeutic, or holistic support.

How do you usually respond when emotions or physical sensations arise during personal work or healing experiences?

What helps you settle or feel balanced after an experience that brings things up for you?

Is there anything about receiving care in a quiet, home-based setting that you would like us to know?

I understand that in-person sessions are structured and time-bound and take place in a private home setting.

I understand these sessions are not intended as crisis or emergency support and do not replace medical or mental health care.

Is there anything else you would like us to know at this time?

Thoughtfully formulated products - Clear, steady education.
Supporting the body’s natural rhythms.