Client Healing Forms

To schedule a healing session in-office, for Skype, or on the phone, please follow the steps below. If you have any questions, call
(858) 472-1857.

Kindly Use a Computer, Laptop, or Tablet To Complete The Following Steps

  • Step 1

    Download the blank fillable Adobe Acrobat forms below to your computer and save them ‘blank’ — or you may print them out and complete them by hand. (You need not include your social security # unless you wish to request a timed payment plan)

  • Step 2

    Fill-out the forms and then ‘re-save’ them on your computer… If you printed forms, they may be completed by hand, and scanned into the computer to be emailed or faxed.

  • Step 3

    Fax your printed forms to (858) 290-7318. Attach digitally completed forms to an email and send them to drmichaelackerman@outlook.com

Forms For Your Healing Session

Please complete, and return all pages of the following four (4) forms. (Two just require signatures.)

The following forms are for your information.
Please review them, they need not be returned to the office.

NOTE: AS OF 7/1/24, DR. MICHAEL ACKERMAN IS WORKING OUT OF HIS NEW HOME-OFFICE. IF YOU ARE SCHEDULING AN IN-PERSON HEALING SESSION, THE ADDRESS WILL BE PROVIDED TO YOU.


IF YOU ARE SCHEDULING A DISTANCE HEALING SESSION:
Once we receive your completed forms, our preferred video conferencing tool is Skype.
Please click on this link to download Skype for your device.

Kindly choose a Skype name, and send a “Hi’ or contact request to: drmichaelackerman_2