E V O L U T I O N A R Y   H E A L I N G   I N S T I T U T E
New Patient Information Forms:

We request that all forms be typed and not hand-written.

You can download the forms (click on the links below), fill them out and then scan to your computer.  Once saved, please email each of your forms to our office at ehmiami@gmail.com   

Any forms that include a signature will be signed at the office during your initial consult and session.

If you are not comfortable emailing your forms to us, you can print your completed forms and bring them with you to your initial consult and session.  However, it is very important that these forms be filled out (typed, not hand-written) and that you remember to bring them to your first appointment.

Thank you!

Patient Services
~  HIPPA Policy    

~  HIPPA Acknowledgement   

~  Financial Responsibility   

~  Cancellation Policy   

~  Pediatric History, page 1   (old form)  

~  Pediatric History, page 2   (old form)  

EH Institute
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Copyright © Evolutionary Healing Institute
All Rights Reserved Worldwide
6601 SW 80 Street Suite 200A South Miami, Fl 33143
ph: 305.667.8174
Here at Evolutionary Healing Institute you will be hearing several different names for the work we are doing together with you. The work we do here, under the umbrella of our overall project called The Unification Project™ is called: Unified Therapy™. This therapy is based on proactive interaction with your own biology.  

Your initial consult and session will consist of your therapist reviewing and discussing your history and questionnaire forms as they explain to you what will go on and what you may experience during your session.
Dominic Petty, a student of Unified Therapy™, interviewed Dr Canali on a Healerology Podcast episode.

During this hour-long interview, they discuss a general overview of Unified Therapy™, the theory and science involved in the process, and how Unified Therapy™ has helped people resolve pain, anxiety, trauma, and much more.

61:18 minutes
6601 SW 80 Street Suite 200A South Miami, Fl 33143      ph: 305.667.8174