I understand that the information contained and presented in these private energy healing sessions done by distance is useful in creating rapid and lasting changes and do hereby agree to use this information only for the purposes of self-improvement and/or to achieve a positive outcome. The power of these techniques requires care, integrity and respect for the highest intention of all individuals.
I certify that my participation in private energy healing session(s) is of my own free will and I accept complete responsibility for my well being at all times.
- You need to know that Rev. Dawn M. is not a state licensed physician or surgeon. Rev. Dawn M. will NOT diagnosis or prescribe medicines or medical treatments for you or recommend that you discontinue legend drugs or controlled substances prescribed by an appropriately licensed practitioner. Rev. Dawn M. neither encourages nor discourages you from contacting a state licensed physician or surgeon.
- Rev. Dawn M. is an ordained minister who has studied and practiced various energy healing techniques. The theory of this technique is that the human body has energy fields that can be affected by subtle energies, focused thought and prayer.
- Rev. Dawn M. only administers various techniques of energy healing to people of their own free will.
- Rev. Dawn M. is an independent subcontractor of Sprinkle Joy Incorporated
- The prayer and energy treatments you will receive are not licensed and are alternative or complimentary to healing arts services.
- There is no guarantee that the treatments you receive will work.
This is not traditional therapy and is not medicine
You will not be working with a doctor, psychotherapist, psychoanalyst, psychiatrist, psychologist, master of family/child counseling, master of social work or legal council. None of the processes, nor the advice you receive here substitutes for medical or legal advice, and they are neither intended as – nor should be used as a substitute for your physician's or attorney's role in monitoring and treating or advising you. If you are taking medication, only your doctor is qualified and authorized to advise you as to its use.
Rev. Dawn M. provides services that are alternative and complementary to healing arts services. Each client will be interviewed, and if it is determined that the services can be of benefit, they will be provided in accordance with the education, training and experience of Rev. Dawn M. .
I, as the Client understand that although private energy healing sessions may raise emotional issues, it is not intended to provide a therapeutic environment or be a substitute for ongoing counseling or psychotherapy and that any unresolved issues which may surface and which may warrant counseling, will be at my own expense.
I further understand emotional change may occur during the processes used at these private energy healing sessions that may affect my relationships with others not involved with the private energy healing sessions. I agree to release and hold harmless Rev. Dawn M. , Dawn Maree, Sprinkle Joy Incorporated and any representatives or agents of Rev. Dawn M. or Sprinkle Joy Incorporated for the results of any portion of the private energy healing sessions in which I am voluntarily participating.
I understand that any personal information provided to Rev. Dawn M. during the course of these private energy healing sessions shall be held in the strictest confidence.
I understand if I am found to be unfit to participate in private energy healing sessions by an agent or representative of Rev. Dawn M. , I will be notified and refunded the cost of the private energy healing sessions and will be required to leave the private energy healing sessions immediately. No questions or discussions will be entered into and Rev. Dawn M. or Sprinkle Joy Incorporated (or their agents/representatives) will be the sole judge.
Limit of Liability & Total Responsibility of Client
Rev. Dawn M. will make every effort to assist me in achieving the results and/or changes for which services are engaged. It is expressly understood that it is my sole responsibility to confirm the effectiveness of any advice or changes, and that I must do so in safety and with appropriate monitoring of my own professional advisor, physician or other licensed healthcare professional.
Rev. Dawn M. offers only a perspective for my consideration. In the course of our work, the conversation may range over a wide range of topics. I hereby understand and acknowledge that anything and everything discussed is merely a perspective for me to consider in conducting my affairs, and any decisions regarding my life is my sole responsibility. Should I wish to seek professional advice in this regard, it is my responsibility to do so with an appropriately licensed, competent, qualified professional advisor.
Rev. Dawn M. or Sprinkle Joy Incorporated cannot be held liable for any damages resulting from our sessions or work together and remuneration is expressly limited to a refund of the amount paid for services.
All changes to session times or dates must be made 4 hours in advance.
I agree that any recorded or written material included in private energy healing sessions is the sole possession of Rev. Dawn M. or Sprinkle Joy Incorporated and may not be reproduced, used or transferred in any way without the written approval of Rev. Dawn M. . As a participant, I AGREE NOT to record this session or any part thereof.
I have read and received a written copy of this Disclosure Form. I understand the contents of this form and voluntarily choose of my own free will to receive the energy treatments as described above: