You must complete this intake form if this is your first BodyTalk session with Sahan. The form serves two purposes:

• Self-Assesment: The form will help you bring into awareness your physical, mental and emotional health, and your stresses such as family, relationships, work and finances that you could potentially improve.
• Evaluation: The form is used at follow-up sessions to evaluate changes you have experienced since the previous BodyTalk session. It allows you and the practitioner to see where there is room for improvement. Evaluating your progress is an integral part of every BodyTalk session with Sahan.

Helpful Tips: Use a large screen device when completing this form. Expand the typing space by dragging down the bottom-right edge of each area. Please answer all questions honestly and to the best of your ability. Fields marked with an * are required. Use brief sentences and note form. Please do not omit questions: If not applicable, please type “NA.” CAUTION: Please do not refresh your browser or use the browser’s back or forward buttons while completing this form as your typed entries will be lost.