Somatic healing
intake form
I understand that somatic healing sessions may involve touch and physical contact, which will always be respectful, consensual, and client-driven. I hereby provide clear written consent for touch as part of our sessions. I understand that I have the right to withdraw my consent at any time.
I understand that the practitioner will respect my boundaries, and I am encouraged to communicate any discomfort or request adjustments at any time during the session. I acknowledge that the practitioner is not a licensed medical professional and does not provide medical or psychological diagnosis or treatment. By signing this form, I confirm that I have read and understood the above information, and I am providing my informed consent for somatic healing sessions. I am also aware that I have the right to review and discuss any aspect of this form with the practitioner before starting the sessions.
(Please note that typing your name & other information into the fields above constitutes your signing & consent to the Southpaw Movement Somatic Healing intake form, and this is required before receiving any Somatic Healing services from Southpaw Movement)