Private Group Session - Intake Form

This private group sound healing session is designed to support relaxation, connection, nervous system regulation, and overall wellbeing through sound and vibration. To help curate a meaningful and personalized experience for your group, please take a few moments to reflect on the questions below.

Your responses are completely confidential and will not be shared with anyone.

Full Name

Age

Phone

Email

Please specify

Is there anything you’re currently experiencing that you’d like me to gently hold space for (stress, major transitions, grief, emotional heaviness, burnout)? No need to share too deeply, just enough to help create a space that is supportive.

If you could leave the session feeling one way, what would that be? Examples: lighter, clearer, rested, connected, supported, empowered, inspired, more like yourself again.

Are there any injuries, chronic pain, or physical limitations I should be aware of?

Please specify

Is there anything else you'd like me to know before I begin curating your session?

Are you comfortable with light touch and the direct application of a tuning fork to send gentle vibrations to specific areas, if applicable?

Yes

No

Optional: A word, phrase, or affirmation you'd like to weave into your session?

What brings you Joy?

Are you ready?!

Thank you for sharing! Your responses help us to create a session that feels meaningful, supportive and uniquely tailored to your family.

I declare that the information I’ve provided is accurate and complete.

By proceeding, I confirm that I have throughouly read and fully understand and agree to the terms and constions outlined in the following link https://www.mysoundhealth.ca/disclaimer

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