HOME > RESOURCES > BIOFIELD TUNING INTAKE FORM Biofield Tuning Intake Form Before scheduling a session, please read the Cautions and Guidance section on the Biofield Tuning FAQ page and information on post session care. If you do not have any of the contraindicated conditions and would like to proceed with scheduling, please fill out this form. Current clients also need to fill out this form in order to give consent for Biofield Tuning sessions. Please enable JavaScript in your browser to complete this form.Name *FirstLastPronouns *Date of Birth *Phone number *Email *Are you a current client or new client? *Current clientNew clientI prefer to be contacted by *TextEmailPhoneChoose all that apply.Can I contact you after your session to check-in? *YesNoPlease mark all that apply and provide any additional health information that you'd like me to know: *Pregnancy or planning to become pregnantCancer or terminal illnessHeart condition/pacemakerConcussion or head injury in the last 6 monthsRecent broken bonesObesityEpilepsyCurrently taking medicationsOtherNone of these apply to meIf other, please explain.What are your health-related goals? *What brings you joy, happiness and/or ease? *Do you have any sensitivities to sound? If so, please elaborate. *Are you familiar with Biofield Tuning? *YesNoConsent to Treat *I grant my practitioner permission to use light touch and the application of weighted forks and/or a crystal on my body. I am aware that I may verbally revoke this permission before or during my session at any point.COVID-19 Statement *I agree to monitor myself for symptoms and reschedule my session if I’m feeling ill or suspect that I have Covid-19. I agree to wear a mask if I am a close contact of someone with Covid-19, and schedule an in-person session at Rocksteady Life, which is located at 275 East 4th Street; Suite 812, St. Paul, MN 55101.Disclaimer (by selecting, you agree to these terms) *Biofield Tuning and its associated processes should not be relied upon as health, medical, psychological, or other professional advice of any kind or nature. Biofield Tuning is an energy medicine* method developed by Eileen McKusick, an author, researcher and practitioner, (www.biofieldtuning.com) for self-healing and wellness that uses sound waves produced by specialized tuning forks in the biofield that surrounds the human body. During a standard Biofield Tuning session, the practitioner uses some hands-on touch and applies the handles of weighted tuning forks and crystals to the body. Energy medicine methods, such as Biofield Tuning, are designed to assess where the body’s energy is blocked, trapped, or not in harmony and then correct the flow of this energy by aligning the body’s energy to boost health and vitality. The theory of energy medicine methods is that the flow and balance of the body’s electromagnetic and subtle energy is important for physical, spiritual, and emotional health, and for fostering overall well-being. You understand and accept that when utilizing Biofield Tuning the practitioner is not “diagnosing” or “treating” the physical body, which is the domain of the medical field and other allied health care professionals, but instead is connecting to the energy or “subtle body” of the client that make it possible to manifest a change or transformation, which is then experienced directly by the client. You understand there is a distinction between “healing” using Biofield Tuning and the practice of medicine or any other licensed health care practice. Although Biofield Tuning appears to have promising emotional, spiritual, and physical health benefits, it has yet to be fully researched by the Western academic, medical, and psychological communities. Therefore, Biofield Tuning may be considered experimental and the extent of its effectiveness, as well as its risks and benefits, are not fully known. Energy medicine methods such as Biofield Tuning are considered “alternative” or “complementary” to the healing arts licensed in the United States. Further, energy medicine methods such as Biofield Tuning are self-regulated and the State of MInnesota does not license, certify, or register Biofield Tuning practitioners.*Energy medicine is a collective term used that refers to a variety of energy techniques, processes, and methods based on the use, modification, and manipulation of energy fields that look at imbalances within an individual’s energy system as well as the energetic influence of thoughts, beliefs, and emotions on the body.Cautions & Guidance *I have read the FAQ page at www.biofieldtuning.com and am aware of the contraindications, cautions and guidance.I have provided my information to the best of my knowledge, including pertinent health information. *FirstLast(or Parent/Guardian if client is under 18)Today's date *Submit