Ear Candling Intake Form

Advance Detox Center

7365 carnelian Street, Suite 204

Rancho Cucamonga, CA. 91730



Have you had Ear Candling before?
Have you had any surgeries or tubes placed in your ears?
Do you have any bleeding of the ears?
Do you wear hearing aids?
Do you have equilibrium problems?
Do you have any allergies or sensitivities?
Do you have any of the following;
What is your general condition of health?
Are you currently being treated by a Doctor?

Thanks for submitting!


What you can expect during and after the Ear Candling session.

 During the Ear Candling session, you will only feel the candle being carefully inserted in your ear. You may hear some cracking and popping when ear wax is being loosened. Just relax and enjoy the face and neck massage done during the Ear candling session.


If the patron has excessive hearing loss, they may feel more heat during the Ear Candling session since their felling senses are keener. If the heat becomes uncomfortable, at your request, the Ear Candler will stop the procedure and continue when you feel it is appropriate.


After the Ear Candling session, you may feel lightness in your head and noises may appear to be much louder to your ears. This can be relieved by putting a little ear oil on some cotton and inserting it in the ears. You will find that your hearing has improved as most likely, the blockage of wax gone.


You may feel warmth or itching in the ears. This can be relived by putting a drop of two of Hydrogen Peroxide in the ears for a day or two after the Candling session, then wipe them out with a cotton swab. The Hydrogen Peroxide will continue to clean the ears and the itching will stop. You may use this same procedure with Echinacea liquid or Colloidal Silver instead of Hydrogen Peroxide.


You may find your sinuses are draining or the drainage has increased. This will relive the pressure in your sinus areas and sinus headaches should decrease. The senses of taste, smell and sight may also be increased.

Twice a year we all have our teeth cleaned to keep our mouths healthy. Why not keep our ears healthy with an Ear Candling session? Use your own judgment as to how often you need or have Ear Candling session.


This is an Old Home Remedy and no claim is made for any cure of any disease or ailment.