HARMONY to Your ENERGY
Doris Poulin, Energy Medicine Practitioner
(719) 360-0954
Healing Touch Body and Mind Wellness Center
104 Dry Mill Road, Unit 102
Leesburg, VA 20175
If you are a first-time client, please print this form, complete it, and bring it along to our first session.
This form will help you clarify your goals for your overall health and vitality, including our time together.
Note: To download Adobe Acrobat Reader for free, click here.