Transfer Interview Checklist - Level 2

Transfer Interview Checklist - Level 2

Student Name: (Please Print)

Last ______First ______MI ____

Address ______

City ______State/Province ______

Zip/Postal Code ______Country ______

Phone ______Email ______

Student has completed Level 1:  HTP or Other, Level 1 TransferDate: ______

Student has completed Level 2 through: Other,Class Dates: ______

Interview Date: ______

Student has reviewed HTP Level 2 Notebook and is familiar with the content.

Student has learned the following Level 2techniques:

 Spiral Meditation

Spiral Meditation on Self

Back Tech: Opening Spinal Energy Flow

Back Tech: Vertebral Spiral Opening

Back Tech: Hopi Back Technique

Mind Clearing (original and modified)

____ Student demonstrated skills relevant to administering and documenting anHealing Touch

Intake Interview.

____ Student demonstrated an understanding of how to administer a one-hour ten step

Healing Touch Sequence.

____ Student demonstrated knowledge of the Spiral Meditation as applied to self and others.

____ Student demonstrated knowledge of back and neck techniques within the Level 2 sequence.

____ Student described the Body Centered Interview with the Chakra Connection and when

to administer it(previously known as the Trauma Interview).

____ Student demonstrated knowledge of administering a Modified Mind Clearing.

____ Student described the application of principles of informed consent as part of the HTP Code

of Ethics and Scope of Practice.

The student:

 Has demonstrated s/he has the knowledge base of Level 2 course work necessary to move on to HTP Level 3 class work.

 Needs further development as described below before progressing to HTP Level 3 class

work through HTP.

Additional Requirements - Level 2

Please outline any additional developmental requirements needed by the student before the transfer may be completed. This sheet should be copied and given to the student for their reference. The original should be sent to HTP with the above checklist once the student has completed the requirements, a second interview has transpired and the instructor has signed indicating the student is ready to move on to HTP Level 3 class work.

Additional action item(s) required for Level 2 transfer completion:

Date of 2ndInterview: ______

The student:

 Has now demonstrated s/he has the knowledge base of Level 2 course work necessary to move on to HTP Level 3 class work.

 Instructor recommends that the student re-take Level 2 through HTP.

Instructor Name: (Please Print) ______

Instructor Signature ______Date ______

Mail this signed form and copies of the students HT class completion certificates to:

HTP 15439 Pebble Gate, San Antonio, TX 78232 or fax to 210-497-8532 or email to

(for office use) Date Transfer Packet received: ______Certificate mailed date: ______