Application Preferred Practitioners | LI Healing Arts

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REIKI TRAINING CERTIFICATION COURSES AT LONG ISLAND HEALING ARTS & LEARNING CENTER

We are grateful for the opportunity to share a spirit of light, compassion, and healing with all who come to our Center.
Your continued support helps maintain and expand our mission and vision.

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*Full Name :

*Address

*Business Name ( if applicable) or Practitioners Name:

*Phone

*Email Address:

Website (if applicable)

Social Media Links (optional)

Do you offer:

In-person sessions

Virtual sessions

Both

Professional Background

**Years in Practice:

*Primary Modality / Area of Practice:

*Credentials / Certification/ “List certifications, licenses, trainings, or credentials”

Professional Standards & Ethics

I confirm that I practice only within the scope of my training, certifications, and professional credentials.

I affirm that I honor and maintain client confidentiality with professionalism, integrity, and respect.

I confirm that I have not had any professional license, certification, or credential revoked, suspended, or subject to disciplinary action.

I commit to practicing with professionalism, integrity, ethical responsibility, and respect for all clients.

*Insurance Answer Yes or No and Name of Provider

*Professional Liability Insurance Options: Yes or No

Choose Your Service Categories : Please select all that apply

Energy Healing

Reiki

Integrated Energy Therapy (IET)

Chakra Balancing

Energy Clearing / Alignment

Distance Healing

Bodywork & Therapeutic Touch

Massage Therapy

Craniosacral Therapy

Reflexology

Myofacial / Therapeutic Bodywork

Somatic Therapies

Sound & Vibrational Healing

Sound Baths

Crystal Bowl Therapy

Tuning Fork Therapy

Vibrational Therapy

Meditation & Mindfulness

Meditation Instruction

Mindfulness Coaching

Breathwork

Stress Reduction & Relaxation

Spiritual Guidance & Intuitive Services

Spiritual Counseling

Intuitive Readings

Mediumship

Energy / Aura Readings

Spiritual Mentoring

Coaching & Personal Growth

Life Coaching

Wellness CoachingIntuitive Readings

Spiritual Coaching

Mindset / Personal Development

Grief Support

Holistic Health & Natural Wellness

Aromatherapy

Herbal / Natural Wellness

Crystal Therapy

Mindset / Personal Development

Holistic Nutrition

Lifestyle & Wellness Support

Movement & Mind-Body Practices

Yoga

Chair Yoga

Therapeutic Yoga

Tai Chi / Qigong

Gentle Movement

Licensed Counseling & Mental Health (Licensed professionals only)

Mental Health Counseling

Psychotherapy

Trauma Support

Anxiety / Depression Support

Classes, Workshops & Group Services

Healing Circles

Support Groups

Development Classes

Certification Programs

Group Healing Sessions

Other Services or Specialties

Primary Category for Listing:

*Service Location (City/Area) (Short Answer) Placeholder: “Ex: Huntington / Long Island / Remote only”

*Client Contact Method/ Phone/Email/Website booking/

*Professional Bio (100 =200 words)

*Brief Description of Services Offered:

MEMBERSHIP SELECTION

**Membership Basic Membership $76-per 4 month term or Annual Membership - $228 per year (paid in full) Limited offer

Four - Month Membership $76

Annual Membership - $228 per year

Membership renews automatically unless canceled prior to the renewal date. All fees are non-refundable

Agreement & Acknowledgement:

I understand membership fees are non-refundable once the term begins

I understand this membership requires a minimum four-month commitment.

I understand membership renews automatically unless canceled prior to the renewal date.

I understand I am an independent practitioner and not an employee, partner, or agent of Long Island Healing Arts & Learning Center or Embrace Light, Ltd.

I am solely responsible for my services, credentials, licensing (where applicable), insurance, scheduling, and client relationships.

I agree to provide accurate and truthful information for my directory listing.

I grant permission for my submitted information and photo to be used for directory listing and promotional purposes related to the practitioner network.

**Professional Integrity Statement Please Write Agree and Check Box

I agree to uphold professional, ethical, and heart-centered practices that reflect the values of compassion, integrity, and respect for clients and the healing community.

*Signature /Date

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Long Island Healing Arts & Learning Center
868 W. Jericho Turnpike, Huntington, NY 11743

Our mission is to create a peaceful space for healing, spiritual connection, and personal growth.
A Teaching • Learning • Sharing Community

“We are each of us angels with only one wing, and we can fly by embracing one another.”

© Embrace Light, Ltd. | © T. Sarin & L. Maglio | www.EmbraceLight.com
All Rights Reserved. Content may not be used or reproduced without permission.

Disclaimer: This website is for informational purposes only and is not a substitute for professional medical care.

Privacy: Personal information is used only for scheduling, communication, and payment processing and is never sold or shared.

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