Vaginal Steam Intake Form

Welcome and thank you for investing in this powerful tool for the health of your womanhood! I am grateful to be part of this incredible journey with you! Please note that all information you submit is strictly confidential. Should I use your info in a case study, your name will not be published. We understand that there are some things that may be emotionally difficult to talk about and I want you to feel completely confident that we are here to offer loving kindness and support.

Before we start, please note that I offer some options for purchase. This intake form is intended for individuals giving a detailed and accurate personal health history. This form is not intended for spa client summaries or to be filled out for another individual.

Consultation and continued support: $35. The Individual Consultation and continued personal online support is a wonderful tool to fine tune your Peri-Steam Hydrotherapy exactly to your current needs. This will give you the most accurate and effective protocol for your priorities and convenience. The support will be online via confidential email.

Consultation and support with herbs for 15 steams: $75 (save $15) The Individual Consultation will identify the very best herbal blend for your target goals. This combo purchase saves you money and ensures you get exactly what you need.

This will ensure that the correct herbs, and detailed steam plan unique to you are provided.

Intake form will be reviewed only after payment is received. Forms are processed in the order they are received and wait time depends on current volume. Protocols are written specifically for each client and are quite detailed. Typically you will receive your protocol within the week.

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