Roberta Weber
New Old Medicine BodyTalk, Acupuncture and workshops

Forms Forms Forms!!

Paperwork is a constant of modern life. It can be a pain, but please be assured the forms I request are all chosen for a good reason. Before working with me, it is essential that I have a completed Consent as well as a GDPR form. The BodyTalk form, is a comprehensive document that allows us to track changes to your health and wellbeing over time, and the Lifeline form is helpful for mapping a lifetime's worth of drama and trauma in order to provide the quickest service. Please note: the BodyTalk and Lifeline forms are not essential and if filling them out is distressing or disturbing in any way, please don't fill them out. The final form is an information sheet about each of the different modalities for you to read. Please don't print it.

The forms can be either printed and brought to the first appointment after being completed by hand, or they can be completed on your computer and sent via email [newoldmedicine-at- gmail.com] (please replace -at- with the @ sympbol) or WhatsApp to Roberta at the number on this website. WhatsApp messages are encrypted and so can infer a higher degree of privacy than email messages. The BT intake and the lifeline forms are the most helpful to have prior to the appointment.


Consent form

This form is essential. Please provide it at the appointment fully completed so we can get to work ASAP.

Forms!. Consent

GDPR form

This form is essential. Please provide it at the appointment fully completed so we can get to work ASAP.

Forms!. GDPR

Information and contraindications for New Old Medicine

Please don't print this form! It's for your information. Any questions - be sure to ask me at your first appointment.

Forms!. NOM info

BodyTalk Intake form

This form is really helpful for tracking changes to symptoms over time but it's not essential. It's a pain to fill out online so you'll probably want to print it, and when you do, save your blue ink by printing it in black and white.

Forms!. BodyTalk Intake

Lifeline Exercise

Filling out this form is like a therapeutic session in itself. You can really see when the stress hit, and what the physical and emotional ramifications were because of that time. If you've suffered a lot of trauma though, it can be a hard one to fill out - so DON'T fill it out if it makes you feel in any way uncomfortable. It's not necessary, but it is helpful for me when it is done.

Forms!. Lifeline

And that's it. If you're doing a distance/remote session with me you will need to get the consent forms back to me before I can do the work.

Thanks! I'm looking forward to working with you!!


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