A PDF of your completed form will be sent to the email address you provide below.

Please include a picture of yourself taken in the last 24 hours (from the waist up, with no other people or pets in the picture, no electronic devices within three feet of your body, no jewelry, and wearing comfortable clothing). This will be used for Gary’s pre-session energy scan. Image must be in the JPG, PNG, or PDF file format. File size must be smaller than 8 MB. There will be a place to submit this file at the end of the form. It might be easiest to have this picture file prepared before beginning to fill out the Client Information Form.