Energy Healing 

I understand that the energy healing session given involves a natural “hands-on” (if in person) method of energy balancing for the purposes of stress reduction and relaxation. I understand that energy healing is not a State-sponsored form of alternative therapy. I understand that an energy healing session is not a substitute for medical or psychological diagnosis and treatment.  

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I understand that energy healing practitioners do not diagnose conditions, nor do they prescribe substances (medications),  prescribe or perform medical treatments, or interfere with the treatment of a licensed medical professional. It is recommended that I see my licensed Primary Care Provider for any physical or psychological ailments I have prior to receiving energy healing. I understand that the energy healer does not guarantee any outcome from our work together.

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I understand that for those seeking treatment who are under the age of consent, the energy healing practitioner requires their parent or guardian sign this form for them as their guardian.  

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I understand that payment of fees (monetary, trade, barter, or any other exchange) for services rendered is an acknowledgment of my satisfaction with the services provided, and hereby release my energy healing Practitioner, Page Mitchum, from any liability in regards to any unforeseen adverse effects resulting from my energy healing session. 

 

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