Prior to your appointment, please read, sign & date this
Agreement & Release Form for
Jessica Leed Malloy; The Sacred Healer; and
Jessica Leed Malloy Integrated Wellness Educator, LLC:
I, ____________________________ (name), before undertaking any participation of any services with Jessica Leed Malloy, The Sacred Healer and Jessica Leed Malloy Integrated Wellness Educator, LLC (Jessica); after full disclosure and understanding of the services to be provided; and in consideration of Jessica agreeing to provide spiritual counseling, coaching, and Transformational Prayer; Somato Respiratory Integration;aromatherapy; and/or other wellness services and education including those of an intuitive and energetic nature, I understand and acknowledge that:
Jessica is not a medical doctor or mental health professional. She will not diagnose, treat or cure any disease or illness. Services provided by Jessica (including but not limited to those listed above, on www.thesacredhealer.com website, in Jessica’s physical locations, and elsewhere) are in no way intended to replace medical advice or treatment, or prescribed health regimes.
I further acknowledge that my participation in Jessica’s services, programs, classes, workshops, phone calls, teleseminars and video conferencing and/or webinars, as well as any subsequent choices or measures I may subsequently initiate, are undertaken by me of my own free will and as a supplement to my existing courses of treatment for any issues/concerns I have. I assume full responsibility for my overall health, wellness and treatment and any specific results or lack of results from participation with Jessica’s services. I agree to tell Jessica about any levels of comfort or discomfort, physical, mental, emotional or spiritual, and any other information which might be relevant to her services or my mental, emotional, physical or spiritual condition. I understand that ultimately my condition, health, happiness and wellness are my own responsibility.
I hereby release, indemnify, hold harmless, and discharge Jessica, her heirs, beneficiaries, relatives, agents and associates, on behalf of myself, my heirs, next of kin, executors and administrators from any and all claims, demands, and causes of action for any damage, loss, illness or injury sustained in anyway in consequence of participating with Jessica, and I expressly assume all such liability, loss, illness, risk or injury.
I have read, understood and agree to the above terms, limitations and conditions concerning my participation with services of Jessica Leed Malloy, The Sacred Healer and Jessica Leed Malloy Integrated Wellness Educator, LLC, and I agree that I am limiting or waiving certain legal rights which I might otherwise have.