Healing Touch Intake Form Healing Touch Intake First NameLast NameEmailPhone/MobileDate of your scheduled Healing Hands appointment:Please complete as many of the following questions as you feel comfortable. This information helps inform the focus of your healing hands session and is sent directly to the healing hands practitioner, JoAnn Yates, CHTP.Where are you Physically? Are there places of discomfort?Where are you Emotionally? What do you feel on a daily basis? Is there something that has surfaced recently?What is your level of stress? What are the top stressors in your life?What is your intention for your healing touch session?Is there anything else you would like for us to be aware of?Submit Form