Healing FeedBack Unique IDFEEDBACK FROM PATIENTSTotal Healing No (Session)(Required) Date(Required) MM slash DD slash YYYY Before Healing(Required) Worst Very Severe Discomfort Severe Discomfort Moderate Discomfort Mild Discomfort No Discomfort After Healing(Required) Total Relief Significant Relief Moderate Relief Severe Discomfort More Discomfort Worst A. Energetic Changes ( Official Use)B. symptomatic Changes ( Official Use) FINAL STATUS OF THE PATIENT (Please make the comments here measurable and specific, you may attach medical reports before and after healing)( Official Use)Signature of PatientAccepted file types: jpg, jpeg, png, gif.Signature of Healer HEALER'S FINAL COMMENTTotal number of healing doneIs the healing still continue Yes No