New Healer or Service Submission Form

Hi Licensees and Managers,

If you have a new healer joining your location or if an existing healer would like to add on a new type of service please fill out the form below.

Please select the one that fits your needs best.
Healer's name *
Healer's name
Please write the healer's name as it should appear on the website. Include Ph.D, L., LICSW, MSW, or other designations after last name as they should appear on the website.
Example: massage therapist, reiki master, psychotherapy, etc
This applies to new healers only. The new healer's bio should include information about their training and specialties written in third person active tense. When referring to your healer's experience, instead of saying "___ has 10 years of experience", say "___ has been practicing since 2009".
Start date
Start date
List each service this new healer performs or the new service/s to be added. Include actual hands-on time and price. (For example: new patient counseling session, 60-min, $85) Buffer time between appointments is entered in the next question.
Massage, acupuncture and energy work buffer time is usually 30 minutes. Counseling and guidance, private instruction, and other services are 15 - 30 minutes. We do not recommend back-to-back appointments in consideration of our clients who may run late due to traffic, weather, and life. However certain service providers have become accustomed to this type of scheduling and we aim to accommodate if this is best for the healer. Note: all appointment are booked in 15-minute increments in MindBody. The total appointment length (hands-on time plus buffer time) must be 15-, 30-, 45-, 60-, 90-, 75-, 90-, or 120-minutes long.
Acupuncture, counseling, and life coaching providers are encouraged to offer free consultations.
Healers who accept packages give their clients more flexibility and we have found this contributes to their success in building a client base. Healers who perform massage, Thai yoga massage, acupuncture, reiki, or other energy healing modalities are encouraged to participate in package pricing.
Include number of sessions, price, and expiration. Most of Green Lotus services expire one year from date of purchase. (Ex: 3 60-min follow-up counseling sessions, $330, expires 12 months)
The addition of a new healer usually includes adding them to the website with their own bio page and inclusion of their thumbnail pic and link on their modality's page. If you feel this new addition requires work beyond this please describe below. An example may be if this modality is new to Green Lotus.
For new healers only. Please upload photos to the Website Team folder for your location. Photos should be in focus, have good lighting, and shot in landscape orientation (wider than they are tall). Avoid selfies. The photo submitted needs plenty of space around the subject because it will be cropped square for thumbnails on the website.
Upload healer's intake form in an editable format to the Website Team folder for your location.
Would you like to print this form for your records?
Press "Ctrl + P" before you click "submit" to print your completed form and/or save it as a PDF.