Select Page

Client Intake Form

Let’s get started! Please take a few minutes to let me know more about you by filling out my Client Intake Form below. Thank you!

My Client Intake Form is very thorough in nature and saves us time by gathering your information up front so that we can devote that time to your coaching session.
This form collects your name, address, phone number, email address and other personal information related to your request for a personal coaching session with Sandy Stearley and Tapping Into Healing with Sandy. Please click or tap here if you would like to view our Privacy Policy and see how we protect and manage the information you submit.
Please let me know which phone number is preferred for me to leave voicemails (if needed).

Don't worry if you're not familiar with EFT. I'll provide you with more information on that.

Do you believe in God / a Divine Creator?

DISCLAIMER

Tapping Into Healing with Sandy, Sandy's Healing Hands and Sandy Stearley (hereinafter referred to as "Tapping Into Healing with Sandy") make no claims, implied or otherwise, regarding the success and/or results from the application of The EGO Tamer® Tapping (aka TET Tapping based in EFT Tapping) and/or personal coaching/counseling (hereinafter referred to as “services”) provided through Tapping Into Healing with Sandy, These services are considered experimental and although success rates are in the 80%-90% range, they are as yet undocumented therapies. Sandy Stearley is NOT a licensed physician, therapist or psychologist. Sandy Stearley is a licensed Massage Therapist in the State of Indiana and holds a certification as an EFT & TET Tapping Practitioner. The emotional or physical frailty of some people is such that they should not attempt ANY healing procedure without the presence of a LICENSED THERAPIST. This may be 2% - 3% of the population. Under all conditions and in all circumstances, you accept full responsibility for your personal health and safety. Your compliance with all of your current medical treatments, therapies and prescriptions is expected. Tapping Into Healing with Sandy, its employees or subsidiaries shall not be liable for any damages or injury arising out of your access to, or inability to access, all services provided. Tapping Into Healing with Sandy, its employees and subsidiaries disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special, or other damages, lost opportunities, lost profit or any other loss or damages of any kind to you or your heirs.

RELEASE

By my signature below, I acknowledge that I understand and agree with the Disclaimer presented above. Also by my signature, I, and my heirs, in consideration of participation in the services provided by Sandy Stearley and Tapping Into Healing with Sandy, hereby release Sandy Stearley, her family, her heirs, and the officers, employees and agents of Tapping Into Healing with Sandy and AO Wellness Center, from any and all liability for any loss or damage caused, or alleged to have been caused, directly or indirectly, by the services provided and/or the information or ideas contained, suggested or referenced during the course of services provided by Sandy Stearley and Tapping Into Healing with Sandy. I understand that my participation in the services provided is strictly voluntary at my own risk and I freely choose to participate in TET Tapping services provided by Sandy Stearley and Tapping Into Healing with Sandy. I understand that Sandy Stearley and Tapping Into Healing with Sandy do not provide medical treatments and/or coverage.

Upon clicking the Submit button below, you will be directed to the payment page for your 45-Minute Right Fit Session. Once I've received and reviewed your client intake form, I'll be contacting you using the phone number you provided and we'll set a time for your Right Fit Session that works for both of us.