New Client Form

All new clients are required to fill in this completely confidential form when booking their first session. This greatly helps streamline the session, and provides the history I need to prepare in advance.

Questions?

Email me:

ash@medicinewalker.com

New Client Intake Form

Your Name*

First & Last Name

Gender Identity (optional)

Male “he/him"

Female “she/her"

Non-binary “they/them"

Trans Male “he/him"

Trans Female “she/her"

Other

Email*

Phone

Address

Please at least include your time zone

What are you interested in?

Shamanic Healing Session

Shamanic Counseling Session

Shamanic Mentoring Session

Healing Song Session

Sylvotherapy (Forest Bathing) Session

In-Person Shamanic Circles

In-Person Shamanic Training

Online Shamanic Circles

Online Shamanic Courses & Workshops

What concerns do you want to ask for Spirit help with?

Please share as much as you're comfortable about what is going on for you and how it's impacting your life.

What do you hope to receive from shamanic healing and/or training?*

Please share as much as you're comfortable about what you'd like to ask the helping Spirits for: help, guidance, and/or healing.

Is there any relevant medical history I should be aware of?

This will remain 100% confidential. I am looking for things I should be aware of regarding medication side effects, disability accommodations, sensitivities and triggers, etc.

Yes, subscribe me to your Substack newsletter.

I honor and recognize the ancestors of this Land,
the native peoples of New Mexico

The 19 Pueblo Tribes: Acoma, Cochiti, Isleta, Jemez, Laguna, Nambe, Ohkay Owingeh, Picuris, Pojoaque, Sandia, San Felipe, San Ildefonso, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Zuni and Zia
The 3 Apache Tribes: Fort Sill, Jicarilla, and Mescalero
The Navajo (Dineh) Nation

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Accessibility Statement

Based in Santa Fe, NM

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New Client Form

Questions?

New Client Intake Form

I honor and recognize the ancestors of this Land, the native peoples of New Mexico

Stay Connected

I honor and recognize the ancestors of this Land,
the native peoples of New Mexico