Healing Touch Session Documentation - Healing Touch Program

Healing Touch Session Documentation
Client: __________________________________
Session Length: ______________ Last Treatment: ______________
Date ____/____/____
Session #: ______
Reason for Current Visit: _______________________ Feedback from Last Treatment: ______________________
R L L R
Top
Front
Back
Bottom
1. Intake / Update:
2. Practitioner Preparation:
3. Pre-Treatment Energetic Assessment:
4. P.E.M.S Health Issues / Problem Statement(s):
Physical
Emotional
Mental
Spiritual
0 5 10
0 5 10
0 5 10
0 5 10
© Copyright Healing Touch Program 1993 - 2006 HTP-922
Session Documentation 03 Rev. 11/06
Permission to copy this form is granted by Healing Touch Program

5. Mutual Goals / Intentions for Healing (short/long term):
6. H.T. Interventions / Treatment:
Level 1 Techniques
____Magnetic Passes: Hands in Motion
____Magnetic Passes: Hands Still
____Magnetic Clearing
____Chakra Connection
____Ultra Sound
____Laser
____Pain Drain
____Sealing a Wound
____Tension Headache (specify)
____Sinus Headache (specify)
____Migraine Headache (specify)
____Chakra Spread
____Mind Clearing
____Scudder
7. Post Treatment Energetic Assessment
8. Ground and Release
9. Evaluation and Feedback
0 5 10
0 5 10
10. Plan (growth work, self care, referrals, appt.)
© Copyright Healing Touch Program 1993 - 2006 HTP-922
Session Documentation 03 Rev. 11/06
Permission to copy this form is granted by Healing Touch Program