Consent & Liability Waiver
Energiya – Geo Love Energy Healing
Practitioner: Betsy Zimmerman, Geo Love Energy Healing Practitioner
Address: 9301 N Park Ave, Indianapolis, IN 46240
Email: know_him@sbcglobal.net | Phone: (317) 509-9151
Informed Consent Summary
Before we begin, please read carefully:
- Energy Healing supports wellness but is not a medical treatment.
- You are responsible for your own health and choices.
- You may stop a session at any time.
- Energiya is not responsible for any specific results or outcomes.
By signing, you show that you understand and agree with the above.
Acknowledgement
I understand that the energy healing services provided by Energiya are intended to promote balance, relaxation, and well-being. They are spiritual and energetic in nature.
Voluntary Participation
I am voluntarily choosing to receive this service and may stop participation at any time.
Medical Disclaimer
I understand that Energiya does not diagnose, treat, or cure any medical condition. I will continue to seek medical care from licensed professionals as needed.
Emergencies
I understand that Energiya does not provide emergency medical or mental health services. In a crisis, I will contact emergency services.
Responsibility & Results
I accept full responsibility for my physical, emotional, and spiritual well-being. I understand that results vary and no specific outcome is guaranteed.
Release of Liability
I release and hold harmless Energiya and its practitioner from any claims, damages, or liabilities arising from my participation in any session. I accept full personal responsibility for my experience.
Confidentiality
All information shared in sessions remains private and confidential unless disclosure is required by law.
Testimonials & Photos
Energiya may use testimonials or feedback only with my written consent.
Minors (if applicable)
If the client is under 18, a parent or guardian must sign this consent form.
