have received information and understand that Spiritual Rejuvenation is a gentle, energy-based approach to health and healing that can assist
my body in its natural ability to heal. I fully acknowledge and understand that this is accomplished with contact and/or non-contact touch.
It has been explained to me that Spiritual Rejuvenation is a therapy not intended to replace any currently prescribed medical treatments as ordered by any physicians, nor any other medical care I have been advised to seek.
I have been informed that Verbena Freg will neither diagnose any medical condition, nor prescribe for any condition that I might have, nor does she make any specific claims regarding results from my Spiritual Rejuvenation sessions that I receive.
I have been informed that all client information and records are treated in a confidential manner. My experiences during these sessions are confidential subject to the usual exceptions governed by state or federal laws and regulations.
I have stated all my known medical conditions to Verbena Freg and if necessary. I will keep her updated on my physical, mental, and emotional health. I acknowledge that Verbena Freg is an intuitive energy healer and is in private practice for the purpose of providing mental, emotional,
physical, and spiritual support using intuitive healing techniques. In case of gross negligence or malpractice. I or my representative agree to fully release and hold harmless Verbena Freg from all claims of malpractice, non-disclosure, or lack of informed consent. I attest that I understand
the nature of the treatment and give my consent to receive healing by Verbena Freg.