Herbalist Consultation Form

Talk to Sanne

Name *

First

Last

Email *

Number

Date, time and place of birth

For birth chart information. This will help me read into your particular constitution and how current patterns may be affecting you.

Permission to read your birth chart

Emergency contact & details

WHAT YOU CAN EXPECT FROM YOUR CONSULTATION: Welcome, we are so glad you have decided now is the time to thrive. Alchemical Herbalism and Ayurveda are systems of natural healing, that has been practiced for thousands of years. With my suport you can begin your unique journey to wholeness through achieving balance in the body, mind and spirit. I may suggest changes to your lifestyle, diet, herbs, color therapy, sound therapy, and other natural therapeutics. By changing your lifestyle and living more harmoniously with nature, you will begin to create within your body the optimal environment for healing. To successfully reach goals and make positive changes it is important that you are an active participant on your path to well-being. Please note that I am not a medical doctor, I serve only to educate in the system of Holistic health and wellbeing. I am not a substitute for medical care, and will not diagnose, treat, or prescribe for disease or pathological conditions. For specific symptoms I may recommend that your condition be evaluated by a licensed healthcare professional or Clinical Ayurvedic Specialist (CAS) or other Specailist. If you are under medical care or the care of another healthcare provider, your work with your me may compliment the work being done by your other providers. Please do not discontinue use of any medications without first speaking to your physician. Intake will be held in the deepest confidence, please fill out to the best of your ability.

yes I understand

Why would you like to work with me?

What is your most pressing concern?

What are the biggest challenges, in regard to your health and wellness, that you are experiencing right now? How long have you been experiencing them?

Are you currently being prescribed any herbs or medications? Please list.

Have you been on any medication in the past, please list:

We begin our understanding of self with exploring patterns, family history, and physical functions in the body. This intake serves as a starting point for understanding and shifting into greater harmony. Are you currently working with a health care professional for treatment? If yes, please include details. For how long? Are you noticing any improvement in symptoms? Are there any past medical conditions (i.e., illness, trauma, addictions, excessive stress, or anything else) that could help us better understand your health and create a plan for lifestyle changes?

Are you interested in:

First Consolation
3 sessions
5 sessions
7 sessions

When would you like to sit down together?

Talk to Sanne

Herbalist Consultation Form

Added to Cart