This survey will greatly help us how to educate and guide you to actualizing your health, wealth and happiness through energetic healing and physical stability.
As a homeopath, Barbara Sakota is always looking for details and what you are experiencing. Your answers on this form will give us an starting point of how you and your body are doing like a snapshop of "right now". It will also serve as a history of what is alive and activated in the body underneath everything else, so that this too might be affecting the "right now". The body tells us what we need to know.
As a medical intuitive and energetic healer, Maryann Castellanos will be using the form to identify your current intention, emotional and mental expressions, and your current stress load. We believe that you and your energy field have everything you need to bring yourself "right". No one else can do it. We can however, help you to prioritize and "open the doors" for greater clarity, strength, and ease in reaching your goals.
Sakota Homeopathy Disclaimer
I, the person filling out this form, realize that I all have the right to make decisions about my body and my own medical conditions. In exercising that right, I have chosen to explore and do what is right for me. I have chosen to explore homeopathy with Sakota Homeopathy as a complimentary and alternative view to my medical health care and wellness practice and I will evaluate it for my own purposes as I see fit.
I choose to consult with Barbara Sakota from Sakota Homeopath regarding the use of homeopathic remedies and herbs. I realize that Barbara Sakota is a graduate of the British Institute of Homeopathic Medicine and is licenced to dispense herbs as a "drugless practitioner". I also realize that homeopathic medicine is not licenced for practice here in the United States. I realize that Barbara Sakota is not a medical doctor, so my consultation with her is for informational purposes only and that she does not practice medicine.
Homeopathic practice does not diagnose nor treat diseases. If I so choose, I have the right to take the homeopathic medicines that might be indicated for my symptomology and corresponding stress that may contribute to any medical condition, and I realize that taking such remedies may or may not help my condition. I realize there are no guarantees of a cure and no guarantees that my symptoms will lessen or improve.
I will not hold Barbara Sakota, Sakota Homeopathy, Maryann Castellanos, Healthy Energetics responsible for a worsening of my current symptoms or any new ones that may arise. I hold them "harmless" for anything that I choose to do or that happens to me while I am in their sessions or program. I realize I am working with these people energetically and I am under no obligation to purchase or use any of their products or take their guidance. I act freely when I take action or make any purchase.
If my exploration takes me into the area of addressing a medical condition, I am not expected to, nor will it be demanded from me, nor suggested to me to stop taking my prescription medicines or to stop seeing my doctor. I have received a clear message from Sakota Homeopathy who strongly urges me to continue with my medical doctor for proper monitoring and that I responsibly inform my health care team of my actions taken in energetic healing and homeopathy so my doctor can properly support me as well. I also certify that I have read the Information Packet about Homeopathy and I understand about homeopathic medicines.
Practitioner Communication Permission
Due to the joint service and support offered by both in sessions with the practitioners and in The Choice Point Program, I give permission for Barbara Sakota of Sakota Homeopathy and Maryann Castellanos of Healthy Energetics to discuss me, my paperwork, my energetic plan, my progress, and my participation in any Healthy Energetics programs.
Signature
Submitting this form represents my signature and agreement to the above.
|
