For each person who will attend the session, please print, complete, and sign each of these four pages:

* Page 4 is the second page of this document: Mathis HIPAA Notice of Privacy Practices. The entire HIPAA document should be printed, read over carefully, and saved for your records only.  Please let me know if you have any questions about these documents.

My Mission Statement 
“As a gentle healer, I co-create a world of love and safety by living in and through my heart.”




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