Emotionally Free - Clear Emotional & Health Issues with EFT
  • Emotionally Free Home
    • Quit Smoking!
    • Fear of Public Speaking
  • What is EFT (Emotional Freedom Tecniques)?
    • EFT Procedure Demo for Clients
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  • Our Practitioners
    • Advantages of working with an EFT Practitioner
  • Pricing & Payments
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  • Book a session
  • New Client Form
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  • Client Feedback Form
  • Russian-speaking clients
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  • Contact Us
  • Emotionally Free Home
    • Quit Smoking!
    • Fear of Public Speaking
  • What is EFT (Emotional Freedom Tecniques)?
    • EFT Procedure Demo for Clients
  • Scientific Research into EFT
  • EFT in the Press
  • Our Practitioners
    • Advantages of working with an EFT Practitioner
  • Pricing & Payments
  • Frequently Asked Questions (FAQ)
  • Client Testimonials
  • Book a session
  • New Client Form
  • Blog
  • Forum
  • Client Feedback Form
  • Russian-speaking clients
  • Legal Disclaimer
  • Privacy Policy
  • Locations & Working Hours
  • Contact Us
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YOUR CART

    Emotionally Free Client Form

    We ask all our new clients to fill out a New Client Form for several reasons. One, we need this for administrative and legal purposes. Two, we would like both you and us to be as prepared as possible before you come to see us, so that we can spend less time getting ready and as much precious time as we can during the session doing the clearing and coaching work. This way you can get the most benefit out of our sessions together. Please fill this out at least two hours before coming to see us.

    Contact details

    Fill this in if you would like to have your sessions over Skype.
    If you have a LivingSocial voucher, please enter the Redemption number in this field so that we can validate it.

    About you

    Please list your current medical concerns and major health issues from the past, any operations you have had, any medications, remedies or supplements you take and for what condition or illness do you take them?
    We respect your beliefs and want to stay clear of any topics that might cause offense.

    Goals / Outcomes / Reasons for working with us

    What emotions would you like to address? e.g. anger, resentment, fear, sadness, hurts, grief, guilt, jealousy, loss, disappointment, stress or other.

    Summary of significant / formative events


    Other comments

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