Intake Form Consent, Disclaimer, & Terms​
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By submitting the intake form for the Energetic Support Custom Essence service, I hereby acknowledge and agree to the following terms and conditions regarding my participation in this service provided by Soulfully Nourish, LLC and it's practitioners.
Voluntary Participation: I understand that my participation in this service is entirely voluntary and that I am under no obligation to accept or follow any advice or recommendations provided to me.
Educational Purpose: I acknowledge that the recommendations I receive are entirely for informational and educational purposed only and is not a substitute for professional medical advice, diagnosis, or treatment.
Assumption of Risk: I understand that energetic essences are used as a complementary therapy and that there may be risks associated with their use. I assume full responsibility for any and all risks, including but not limited to physical, emotional, or
psychological effects, that may arise from my participation in the recommendations given to me.
No Guarantee of Results: I acknowledge that Soulfully Nourish, LLC and it's practitioners do not guarantee any
specific outcomes or results from the Energetic Support Custom Essence service and that individual experiences may vary.
Release of Liability: I hereby release, waive, and discharge Soulfully Nourish, LLC, their practitioners, and any affiliated institutions from any and all claims, liabilities, demands, or causes of action that may arise from my participation in the service, whether caused by negligence or otherwise.
Confidentiality: I understand that all information shared in my intake form or in relation to my intake form will be kept confidential to the extent permitted by law, except in cases where disclosure is required for the safety of the client or others.
Informed Consent: I certify that I have read and fully understand the terms of this Waiver of Liability. I have had the opportunity to ask questions and have received satisfactory answers. By checking the box and signing the Energetic Support Custom Essence intake form, I voluntarily agree to the terms and conditions stated herein.
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