Emotional Integration System Intake and Release Form

Please download this form, open in adobe acrobat, fill it out and sign it then “save as” so you can email your filled out copy here.

Or print it, fill it out legibly and send a clear photo of it here once completed prior to your first Emotional Integration System Study appointment.

If you need assistance with any of these steps, please email me.

This form MUST be filled out and sent PRIOR to your first appointment. Thank you for your understanding!