Post-Energy Healing Session Questionnaire

First name

Last name

How did you feel physically after your the session?

Much better

Somewhat better

The same

Worse

How did you feel emotionally after the session?

Calm and Centered

Mildly Improved

Unchanged

More Stressed

Did you experience any specific sensations during the session? If Yes, please describe:

What was the most significant part of the session for you?

Do you feel any shifts in your energy or mindset?

Significant Shift

Minor Shift

No Change

Is there anything else you’d like to share about your experience?

Date

Month

Day

Year