hum
  • About
    • Sarah Knight PhD
    • Why hum?
    • Booking, Fees & Policies
  • Offerings
    • Workshops + Training
    • Classes + Gatherings >
      • DeStress and ReCharge
      • Yoga Nidra
      • Sit In the Light Night
      • Improv for Humans
      • Field to Form
    • Healing Sessions
    • Podcasts
    • Blog
    • Free resources
  • Contact
  • Book Now
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Intake Form

This form will help me prepare to meet you. The information you provide will remain confidential.

    Symptoms and Goals

    ​What areas, concerns, or goals would you most like help with now?

    Medical History

    Please list the main other healthcare practitioners you are seeing:
    Please list any surgeries, major illnesses and other traumatic or life-threatening experiences (and indicate the year or your age)

    Lifestyle

    How much and how often do you consume the following:

    Family History

    Are you aware of any major traumas that your parents or any of your immediate ancestry (grandparents, great-grandparents, aunts or uncles) experienced? 
    On a scale of 1-10, how much belonging do you feel now in your family of origin? (even if your parents have passed on and you don’t have any siblings, how much do you feel your place in the lineage)

    Energy and Emotional Health

Submit
  • About
    • Sarah Knight PhD
    • Why hum?
    • Booking, Fees & Policies
  • Offerings
    • Workshops + Training
    • Classes + Gatherings >
      • DeStress and ReCharge
      • Yoga Nidra
      • Sit In the Light Night
      • Improv for Humans
      • Field to Form
    • Healing Sessions
    • Podcasts
    • Blog
    • Free resources
  • Contact
  • Book Now