Consent Forms

[Guest guest]

hugs and kisses Barb,

I hope this is what your talking about.

I have 2 forms my clients fill out. One is an intake form. It ask

for name, address etc. I also have on that form

Chronic, Hereditary or Congenital problems:

have you had any surgeries or hospitalization?

medication taking now? If so what is it?

have you had any counseling before?

Have you had any experience with crystals or stones?

What attracted you to crystal healing?

Have you studied with any spiritual teachers? If so, who?

Do you have a spiritual practice?

What emotion do you feel you least express and what emotion most express?

What is challenging and happening right now?

Please summarize what you want to accomplish during your crystal healing?

 

The 2nd form is a release form:

I, (Clients name here), hereby request the service of felecia angela,

for the purpose of assisting me to access my own inner resources of

healing energy so that I may learn to heal myself. I understand that

while felecia angela may make certain suggestions that will assist me

to direct my spiritual healing energies into my mind and body, felecia

angela is in no way diagnosing or prescribing on my behalf. I hereby

release felecia angela from any and all liabilities or claims of what

ever nature that may resulf from this crystal healing session or from

my failure to persue medical remedies for any physical ailments I may

have. I acknowledge that I have not been dissuaded by felecia angela

from pursuing such prescribed medication. I understand that I am free

to seek other help from whatever sources I desire. I release felecia

angela from all liabilities and claims of any kind arising from

felecia fischer services.

My estate, heirs, administrator and executors are bound by this

release also.

(clients signature)

or of family member present. state relationship (Signing on clients

behalf/request)