NEW CLIENT

Electronic Intake Session Forms

 

Thank you for scheduling your LENS Neurofeedback Intake Session! To help us prepare and make the most of your appointment, please complete the three required intake forms no later than 24 hours before your session.

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LENS Informed Consent Form

Note: If you self-booked your LENS Intake Session, you have already submitted this

form during the booking process, and will only need to complete the following 3 forms. 

 

LENS Intake Form

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LENS Sensitivity Questionnaire

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LENS Central Nervous System Questionnaire

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Completing these forms in advance ensures we can review your information thoroughly and tailor the session to your needs. If the forms are not submitted at least 24 hours before your appointment, we will need to reschedule.

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If you have any questions or need assistance with the forms, please don’t hesitate to reach out.

Looking forward to supporting you on your wellness journey.

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Adriena Dame, MFA

LENS & CranioSacral Practitioner

Holistic Wellness Mentor

HighVibe Mettaverse Founder

Mettacine Woman Founder

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LENS TRACKING FORMS

 

LENS Weekly Progress Tracker (electronic)

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LENS Weekly Progress Tracker (printable)

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