New Client Form

Hello, Wild One!

I'm so glad you're here.

Please fill out this short form if you are interested in working 1:1 either via Zoom or in person.

This information will give us a place to start from so we can make the most of our time together. At the bottom of the form, there is a place for you to choose a free call and/or to sign up for your first session.

First name

Last name

Phone

Birthday

Month

Day

Year

What are you most desiring support around right now?

What is something you desire as an outcome from working together?

What do you feel are your biggest challenges and struggles right now?

If we work in-person this is hands-on work. Is there anywhere you prefer to NOT be worked on?

Do you have any fears, questions, or concerns about this process you would like to share with me here?

Do you have any experience with therapy, coaching, yoga, personal development, other forms of bodywork, mindfulness practices, meditation, etc.? If so, please describe.

Have you ever been treated for a serious mental, psychological, or physical health issue? If so, please give a brief description.

Anything else you would like me to know?

How would you best like to communicate during this journey?

Email + Text

Mostly text

Where you referred by someone? If so, I'd love to know who!

Liability Waiver

As the Bodyworker, Aspen Marino agrees to:

Stand in service to your growth and transformation.
Uphold standards of ethics and professionalism.
Be an unwavering advocate for your potential, power, and possibility.
Respond to emails, questions, and challenges within 2-3 business days when outside of designated office hours (Mon-Fri 10-4).
Communicate with you 24 hours in advance if a session needs to be rescheduled or canceled.

We both agree to:

Treat ourselves and each other with respect and compassion.
Be on time.
Trust and give space to whatever might come forward for healing.
Take full responsibility for our needs, actions, and experiences.
Stay curious

Cancellation Policy: If you need to cancel or reschedule an appointment, please notify me at least 48 hours in advance so there is an opportunity for someone to get in. If less than 48 hours notice is given you will be charged $30, if less than 24 hours notice is given, 50% of the session fee ($65) will be charged. No-show, no-calls will be charged the full amount ($130$)

Confidentiality: Everything that happens in this container is held with the utmost confidentiality. You are free to share anything from your experience in any capacity you wish, but I will keep everything to myself, and share nothing from our sessions unless otherwise agreed upon by us both.

Liability Release: I understand that this work involves hands-on touch (if in person) and vulnerability. This container and its contents are not a substitute for psychiatric, medical, or any other kind of professional support that may be needed. Any boundaries or issues that arise must be addressed immediately and communicated clearly.

By signing below, I acknowledge that:

I voluntarily participate in these 1:1 sessions (in-person or via Zoom)
I assume full responsibility for any injuries or damages that may occur during the session.
I understand that Aspen Marino will not be liable for any actions I take or do not take as a result of these sessions. No assumption of responsibility is made or given.
I take full responsibility for myself in this container.

Signature

Signature field is empty.

What happens next? Either schedule a free 15-minute chat with me to talk more or book your first session if you haven't already done so!

Free 15-minute phone call

Free 30-minute Zoom call

In-person first Bodywork session $150

Via Zoom first Bodywork session $150

I've already booked!

I look forward to meeting you!

If you have any questions, don't hesitate to reach out.