Client Intake - Letting Go for Life

Name*

First Last

Account Email*

This is the email associated with your appointment.

Phone*

Release*

I agree to fully release and hold harmless Amy Hill from and against any and all claims or liability of any nature arising out of, or in connection with, my sessions.

I agree to release and hold harmless

Universal Information

I understand that sometimes universal information is provided through the client to benefit all of humanity. I agree to allow Amy Hill to share this information and any accompanying story summary either in audio or video format or in written form in blogs or books as long as my identity, name and all details that may be considered personal or linked to me are omitted or changed.

I allow sharing of universal information (optional)

Terms and Conditions*

I am willing to be guided through relaxation, visual imagery, hypnosis, and /or stress reduction techniques.

I understand the above techniques are non medical and it is my responsibility to consult my physician before or after my session regarding any and all medical concerns. I understand the above techniques are not substitutes for regular medical care and I am advised to consult my regular medical doctor or health-care practitioner for treatment of any old, new or existing medical conditions.

I take responsibility for the results of my session. I understand that ALL HEALING IS SELF HEALING and that Amy Hill is only a facilitator in the process of helping me to work through my issues.

I understand that it is my responsibility to be open and honest before, during and after each session, provide information that may help me achieve my desired outcome,
be communicative and forthcoming with details during the session, and provide accurate feedback after the session in order to achieve maximum results.

I understand I may receive advice and or instructions during my session from an inner source. I understand that this communication does not come from from Amy Hill and I am free to disregard this communication as I see fit. I am under no obligation to use any information given to me during a session.

I understand that Amy Hill may elect NOT to proceed with the session if she feels it is not in her or your best interest to do so. Such a situation would be considered extremely rare and generally result from the client withholding pertinent information prior to the session. In such cases, I am responsible for costs related to the session such as travel costs (airline, hotel, etc.).

I understand that our session may be digitally recorded for my later use. I also understand that the energy in the room can affect the equipment and recording resulting in static or blank recordings. So a recording is not guaranteed.

I understand that this agreement will apply to any and all sessions with Amy Hill and may only be revoked by signing a new agreement.

I agree to the Terms and Conditions

Signature*

By signing this document, I attest I have read and understand it.

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