Earth Horse Healing

Ginger Krantz - Healer, Teacher, Mentor

Energy Healing Session Intake Form

Please fill out and submit this form at least 48 hours prior to your initial appointment. Required fields are marked with a red asterisk. The information you provide is held as private and will not be shared without your expressed permission.

  • General Information

    Please check all times you are available Eastern Time.

  • Presenting Issue(s)

  • MM slash DD slash YYYY

  • Lifestyle

  • Employment, child rearing, caregiver
  • Please list activities and amount of time you engage in them per week.
  • Food and environmental. Are you on a special diet?
  • Daily, weekly, occasionally

  • Medical History

  • If so, include any diagnosis and current medications.
  • High/low blood pressure, disorders, attacks, past surgeries, pacemaker, etc.

  • Healing Session Preparation