I, _____________________________________________________________________________________, am here to enter into my own personal discovery and transformation. It is understood the purpose of a Healing Session (including the following modalities:  Intuitive energy healing, Reiki, Coaching, Hypnotherapy, Crystal Healing) and/or other treatments used is not meant to diagnose, or treat any illness, disease or any other physical or mental disorder, injury or condition. This treatment is a supplement or addition to whatever treatment you are currently receiving or may seek in the future. I have sought this spiritual service combined with spiritual counseling of my own free will.

My heirs, guardians, legal representatives, and I hereby and forever release, discharge and waive any claims against, Anne Clausen or any of her associates or affiliates connected with Anne Clausen, Empathic Intuitive Healing.

I take full responsibility for any loss or injury incurred while applying techniques and information learned from Anne Clausen in association with my healing journey.

I have carefully read this agreement and understand it in full. I am aware this is a waiver and release of liability and a contract between the members listed in this form. I understand this is a binding contract and I am signing of my own free will.

CANCELLATION NOTICE:   24 – hour notice is required for cancellation. Cancellation may be made directly to Anne Jacobsen Clausen through this week site email or phone message.  Missed sessions or cancelled sessions without 24 – hour notice will result in a cancellation fee of half the session cast.

I understand and agree to the above statement and cancellation policy.