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Client Consent Form & Liability Waiver

This is an agreement between me, the client, and the certified Krystic Energy System® (KES) practitioner, Janet Smith, concerning the Krystic Energy Healing Session(s) and upon paying via this website , I, the client, agree to all terms laid out in this agreement and in the general Terms and Conditions.

I agree that I am here to inspire my own personal transformation.  I take personal responsibility for my well-being and with respect for myself I gratefully accept control of my choices.  My heirs, guardians, legal representatives, and I hereby and forever release, waive, and discharge any claims against 4 Body Healing or Janet Smith and/or any of their associates or affiliates. I have carefully read this agreement and fully understand its content.  I am aware that this is a waiver and release of potential liability and a contract between the above noted parties and myself.  I understand that this contract is binding and acknowledge that I am signing this of my own free will.

   1.  I am at least 18 years old, the age of consent to make any decisions as to my person and treatment. 

   2.  I authorize and request my KES practitioner to carry out Krystic Energy System® sessions. I understand the process of these sessions will be explained to me upon my request and that they are subject to my agreement. I also understand that while the course of my session is designed to be helpful, my practitioner can make no guarantees about the outcome of my session. Further, I understand this process can bring up uncomfortable feelings and reactions such as anxiety, sadness and anger and/or may provoke a healing crisis. I understand that this is a normal response to working through unresolved life experiences and that these reactions are preventing greater negative outcomes.

   3.  I agree I will not hold 4 Body Healing or any of its employees or representatives, or the certified Krystic Energy Server practitioner liable for any adverse effects, injury, harm, illness or damage alleged to have been caused by the use of the methods and techniques of  the Krystic Energy System®

   4.  I understand that the Krystic Energy System® is a supplement to medical care, not a substitute for it.  If I am currently under the care of any health care provider, it is recommended that I continue to follow all treatments that have been prescribed for me. If I believe that I have significant health issues or am currently in need of medical care for any reason, it is  recommended that I consult a doctor as soon as possible.

   5.  I understand that as part of an in-person session, the KES practitioner may lay his/her hands lightly on my body, particularly on the heart and or head. However, this will be done only with my consent and I will remain fully clothed during my session.

   6.  I understand that a Krystic Energy System® session is intended to help me, the client, and any medical or psychiatric issue or condition that occurs during or after the KES session is not the responsibility of the practitioner. In addition, the KES practitioner will not be held liable for any information withheld by me as to my medical or emotional conditions. I will not hold the practitioner responsible or seek compensation for any injury or illness suffered by me caused in whole or in part by my participation in this KES session.

   7.  I understand that receiving a Krystic Energy System® session does not replace traditional medical or psychiatric care and that if I am under current medical or psychiatric care I should not stop treatments or medication without advice of their physician/psychiatrist.

   8.  All information between the KES practitioner and me, the client, is held strictly confidential.

There are legal exceptions to this:

a.  The client authorizes a release of information with a signature.

b.  The client presents as a physical danger to self or others.

c.  Abuse and/or neglect are suspected.

d.  The client is under criminal investigation and a subpoena by a court of law has been issued for information on the client.

In the case of #b or #c above, we are required by law to inform potential victims and legal authorities so that protective measures can be taken.

    9.  I understand that I am responsible for payment of all fees charged at the time of service to be paid either prior to (website booking) or on the day of service (in-person). I agree to pay for all services rendered.

    10. I am expected to arrive on time on the agreed upon appointment date and time. If I am 15 minutes or more tardy, then I will be charged for this time accordingly. Cancellations must be made at least 48 hours prior to appointment; otherwise I will be responsible for the full cost of the session. Should there be an emergency, no charge will be made, however, proof of said emergency will be required to void payment requirement.

   11. The KES Practitioner reserves the right to refuse any session without providing a reason and can cancel said session at any time. Any payment made prior to a session that is canceled by the practitioner will be refunded in full.

   12. I understand that my relationship with my KES practitioner is entirely professional and so any behavior on my part that is not professional and can be deemed sexual or abusive will be reported to the authorities.

By booking and paying for a session, I certify that I have read and understand this agreement and have full knowledge of its meaning and effect. If I violate the agreement, I know that the KES practitioner may discontinue sessions.

I understand very clearly that a Krystic Energy System® session Is not a substitute for medical, or psychological diagnosis, and treatment. I understand that KES practitioners do not diagnose conditions, nor do they prescribe, perform medical treatment, nor prescribe substances, nor interfere with the treatment of a licensed medical professional.

I understand that it is recommended that I see a licensed physician, or licensed health care professional for any physical, or psychological ailment I have.

Disclaimer: Nothing in this document or in the Krystic Energy System® is being offered as legal advice or legal counsel. You are advised to seek an attorney or legal advisor for any of your professional legal issues, local laws regarding energy healing and concerns or needs.


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