Before booking for the first time:

1.Complete Client Intake Form below

LFT Session - Client Intake Form

Please fill out the following form to help us understand your condition.

All personal information on this form is held securely, will be treated as strictly confidential and is only for the purpose of making LFT treatment the best possible.

Choose which LFT Session you have booked
Did you try to solve or to heal that problem on your own or by attending other specialist/therapy/other?
Are you undergoing some other life coaching, psychotherapy, hypnotherapy or healing right now?
Are you under medical treatment which uses drugs or medication which affects your state of mind, neurological/emotional state, or physical state?
Do you have any experience with relaxation, meditation practices, breathwork or hypnosis?
If you are in pain right now, please specify from “0” to “10” – how intense is that pain right now.
Do you confirm that all those personal information included in that form are 100% genuine and the answers provided are nothing but the truth?

    Client Statement

1. Client states, that is totally aware that LFT life coaching or any other LFT Sessions are NOT psychotherapy treatment or medical treatment of any kind. LFT Sessions are an alternative way to solve/to heal the problems or achieve the goals which are set during the LFT Session.

2. Client understands that LFT life coaching or any other LFT session are NOT to be used as a substitute for professional advice by legal mental or medical or other professionals and will seek independent professional guidance for such matters.

3. Client understands that LFT life coaching or any other LFT Sessions are not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat mental disorder or medical disease .

4. If Client is currently under the care of a mental health professional, LFT practitioner recommend the Client inform mental health care provider about booking LFT session. Especially those which contains meditation, breathwork, re-frame subconscious, altered state, alpha-theta state, hypnosis. Client may need a refferal letter from mental health care professional.

5. Client understands that LFT life coaching or any other LFT Sessions are partnership between the LFT Practitioner and the Client in a thought-motivating and creative process that inspires the client maximize personal or professional potential.

 

6. Client is responsible for creating and implementing his/her own physical, and emotional well-being, decisions, choices, actions and results. such, the Client agrees that the LFT Practitioner is not and will be liable for any actions or inaction, or for any direct or indirect result of any services provided the LFT Practitioner.

7. If Client decides hide or change any of personal information included in the Intake Form and if it will have negative impact at the Client or at any part of the LFT life coaching or any other LFT Sessions process, then it will be Client’s personal responsibility.

 

8. Client agrees communicate honestly, be opened to feedback and assistance and create the time and to participate fully in theprogram.

CONTACT

Address: Perth/Safety Bay 6169 WA

 

Call us:

​​​​​​​​​​​​​​​​​​​​Ph: +61 8 95286097  M: +61 04526119

Monday - Friday: 9 am - 7 pm 

 

Email: lftcoachingewamay@gmail.com

Messenger: https://www.facebook.com/ewa.may1

 

Skype: indigo1400

 

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