Session Intake Form

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Do you prefer a phone call or a zoom video conference (password-protected for privacy) for your session? (Choose one) *

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City and State in which you will be located during the reading *

What brings you in for a session? What do you hope to receive from it? *

Where in your body do you experience pain, discomfort or other sensations?

Is there anything else you would like to let Uma know?

DISCLOSURE STATEMENT AND IMPORTANT INFORMATION about Energy Healing and Tarot Reading: Energy Healing is a natural method of energy balancing, but is not meant as a substitute for medical, or psychological, diagnosis and treatment. Energy practitioners do not diagnose conditions, nor do they perform medical treatment, prescribe substances, or interfere with the treatment of a licensed medical professional. Energy therapy or any other natural healing therapy should not compete with medical doctors and their treatments. All therapies are meant to complement medical treatments. Tarot Reading is a form of self-reflection. A tarot professional does not predict the future and you should not rely on a tarot reading to make any decision that would affect your legal, financial, or medical condition. A tarot reading can only facilitate how you cope spiritually with a given situation. In certain jurisdictions, a tarot professional is required to disclose to you that tarot readings should be for entertainment purposes only, and if such a law applies to your reading, then you are hereby on notice thereof. Your tarot professional is bound by a self-imposed code of ethics, which can be provided to you upon request. PLEASE TYPE YOUR NAME BELOW to indicate that you have Read and Understand these Disclosures and do not hold Uma Bode responsible for your decisions or for the twists and turns of your own life path. *

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