Various session Intake form
Primary
Marital Status *
What kind of support are you currently receiving? *
May we connect with your Support Team? *
Are you taking any medications? *
Are you experiencing any of the following: *
Do you have a spiritual foundation in your life? *
Are you currently working in a shamanic or mediumistic tradition? *
Please acknowledge our 5 business day cancellation and rescheduling policy. True emergencies are accepted. Otherwise, full fee is due for all scheduled appointments. First-time appointments are prepaid. *

Two step process ~ please fill in the form and then make the payment


Welcome to my practice!

As you are initiating contact, I would like to familiarize you with the process of here at Ancestral Realms.

Appointments are set on an individual basis: Monday through Friday 10 am – 5 pm.

Meetings occur in-person or via phone/zoom.

Setting appointments occurs via email, phone or in person. Please keep email and phone messages concise and business oriented. We apologize there is no text-ability. All personal information is to be shared during our in-person-times together.

Payments are made by check, cash or electronically (additional fees may apply). Your first time session requires two scheduled events:

  1. An initial 20-30 minute phone contact to discern the focus and compatibility of working together.
  2. The Spirit Clearing itself (generally 90 minutes)
  3. The first time consultation fee is $290

Cancellation Process: For one on one appointments we have a reservation with you and give up other appointment opportunities to accept yours. As time and space is set for you, we practice with a 7 business day cancellation or reschedule policy. If you are unable to keep your scheduled appointment, kindly provide notice by calling: 610-513-2757. Business days are Monday through Friday.

Cancellation rates: Missed appointments or late cancellations are full fee. True emergencies are most certainly honored and free of charge.

Thank you for taking the time to prepare me to work with you competently. I look forward to meeting and exploring with you how to be of service to you!

Once your registration and payment is received, the next step is to set your session times. I will contact you as soon as I receive all of your information – no more than 3 business days past reception.

Kindly,

Andrea Bosbach Largent, msw, sft

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