Name *

First Name

Last Name

Phone

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Health Disclaimer & Acknowledgment *

This session is designed to support your spiritual and emotional well-being. It is not intended to diagnose or treat any physical or mental health conditions. Always consult your healthcare provider for medical advice. Your safety, comfort, and consent are always honored. Note: If you are currently under medical or psychological care, this service may be used as a supportive practice in addition to but not in place of your ongoing treatment.

Yes, I understand and acknowledge

No, I do not understand nor acknowledge this statement

Social Media & Promotion Consent *

I love sharing glimpses of the healing journey to inspire and educate others about spiritual wellness. With your consent, I may share photos, videos, or written testimonials on platforms like Instagram, TikTok, Youtube or my website.

I consent to being photographed or recorded during or after my session, including my face

I consent to a written testimonial being shared (you may quote me anonymously or with my first name)

I do not consent to any photo, video, or testimonial being shared