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Client Information and Agreement Form

YOUR OWN DETAILS:

YOUR EMERGENCY CONTACT DETAILS:

Responsibilities and Liability Release

 

1.  I am willing to be guided through relaxation, visual imagery, hypnosis, and/or stress reduction techniques. I am aware that these modalities are spiritual-based and non-medical in nature and it is my responsibility to consult my regular doctor about any changes in my condition or changes in my medication.

 

2.  I understand the above modalities are not substitutes for regular medical care and I have been advised to consult my regular medical doctor or health-care practitioner for treatment of any old, new or existing medical conditions.

 

3. I understand that being hypnotized is not being asleep. During a deep hypnotic trance, you can open your eyes, speak, laugh, walk and you may be aware of everything that happens around you. You can even open your eyes and think it is not working and are not hypnotized. But when you allow those feelings or thoughts that come to your mind to flow freely as Chrysilla Lewies speaks to you, you will relax and remember forgotten events in this life or a past life.

 

4. I understand that change is my own and complete responsibility. I understand all healing is self-healing and that Chrysilla Lewies a is only a facilitator in the process of helping me to solve my own problem(s). It is my responsibility to be open and honest, provide accurate feedback and be forthcoming with details and information that may help me achieve my outcomes.

 

5. I understand that our session will be digitally/voice recorded for my later use and that and Chrysilla Lewies retains the copyright of these recordings. I also understand that in these types of metaphysical sessions, the energy in the room can affect the equipment and recording resulting in static or blank recordings. 

 

6.  I understand that often in Hypnosis sessions, universal information is provided through the client to benefit all of humanity. I agree to allow Chrysilla Lewies to share this information and any accompanying story either on video or in written form in blogs or books as long as my first and/or last name and all personal and relevant details are omitted and/or changed. (On videos, you will agree on what to omit.)

 

7.  I understand that if I make travel arrangements to see Chrysilla Lewies, I will not hold Chrysilla Lewies responsible for any costs incurred, such as travel or hotel, in the event that the session is cancelled.  We strongly suggest you protect yourself with Travel Insurance.  In the event of a disaster (natural or man-made), emergency, accident or illness, sessions can be cancelled on short notice.  Chrysilla Lewies will not conduct a session if she is ill.

 

If an appointment is missed, there are no refunds.


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Thank you for submitting your details in preperation for your Quantum Healing Session.

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