Yes I would like to book a Flower Essence Therapy!

I am able to offer Flower Essence Therapy one to one , this can be done online email/messenger (email or whatsapp) appointment or as a video chat (I will send a link, I use a platfom called Zoom) or by telephone.
The consultation can last up to 2 hours and we will discuss in detail your current lifestyle, health and well being, your intention for taking essences and set a goal for 4-6 weeks. You will then be provided a personalised combination dosage bottle of essences 30ml to take for that period of time. During the consultation we may also work with other mediums such as journalling, goal setting, cards, colour, dowsing and or muscle testing.

In order to make the most of our interaction I ask all my clients to complete a consultation form. You can now do this online. All my forms and contact deatils are below. Please contact me and we can make a plan on how to start your essence journey of support.

If you have any questions about this process please get in contact with me and I will be happy to help.

Flower Essence Online Consultation Form

Full Name:*
Address (including postcode):*
DOB:*
PHONE:*
EMAIL:*
PERSON TO CONTACT IN AN EMERGENCY:*
EMERGENCY CONTACT NUMBER:*
DOCTOR NAME AND ADDRESS:*
CURRENT MEDICATION:*
HAVE YOU HAD THIS THERAPY BEFORE?:*
What difficulties/problems do you find yourself having to deal with currently? How would you describe the emotions attached to any of the problems?:*
How would you describe your current lifestyle/circumstances?:*
How has your general wellbeing been in the last week 1 as bad as it could be…. 2… 3… 4 …5… 6… 7… 8… 9… 10 as good as it could be:*
COMMENTS (if you would like to share):
Please write a short goal for what you would like flower essences to do for you (how would you like to feel in say 4 weeks time):*
Please write a long-term goal for what you would like flower essences to do for you? (say in 6 months or more ):*
What is your main reason for wanting to try essences?:*
Disclaimer and Signature - By Ticking this box you are confirming you have read and agree :
- To my personal information being collected electronically
- I have read the Privacy Policy and Disclaimer
- Agree to a Complementary Therapy

This is a Holistic Complementary Therapy and the treatments given are not taking the place of Conventional medicine. You will be advised to seek medical attention when needed. Every effort is made to encourage patients to give full details of any other treatment they have received or are receiving from whatever direction.

By signing this form, you agree that you have read the foregoing notes and confirm that they are a true record. You have not withheld any information which might affect the course of your treatment and you undertake to keep your therapist Informed of any changes in your health and in any prescribed of self-administered medication in order to facilitate an update of this record, when necessary.

The information you have given is strictly Private and Confidential.

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Thank you for submitting the contact form.

Contact me by phone

07525481213

Contact me by Email

[email protected]