I'm S.H.E.'s Soul Guidance Readings Acknowledgment and Consent Form

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Please read and respond to each statement below to acknowledge and give consent to Soul Guidance Reader, Shanique Worthey, Ed.D., of I'm S.H.E.'s to provide you with a soul guidance reading. If you have any questions while completing this form, then please send an email to ImSoulHealingEnergy@gmail.com or call/text 678-367-9012.

Email *

Date of Birth *

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First Name

Last Name

How did you hear about this service? *

I acknowledge that a Tarot or Oracle reading is never a substitute for medical, psychological, financial, or legal counseling. For those who are suffering severe symptoms of depression, anxiety, trauma, or other ailments, please contact Professional Medical and/or Psychological Services in your area. *

I acknowledge

I don't acknowledge

Required

I acknowledge the information provided in a Tarot or Oracle reading is not legally binding. I'm S.H.E. (Soul Healing Energy), LLC can assume no legal liability for any damages, losses, or other consequences of any client decisions, subsequent to, or based on, my Tarot or Oracle readings. *

I acknowledge

I don't acknowledge

Required

I acknowledge, that I have the free will to choose whether or not they will follow any guidance gained in a Tarot or Oracle reading. The client is therefore responsible for their actions following their reading. *

I acknowledge

I don't acknowledge

Required

I acknowledge, that this Tarot or Oracle reading is provided only at the request of the person for whom it was prepared. The person requesting this Tarot or Oracle reading affirms they are at least 18 years of age. *

I acknowledge

I don't acknowledge

Required

I understand that by providing this informed consent I am assuming full responsibility for my services and I hold harmless both the soul guidance reader, Shanique Worthey, and I'm S.H.E. (Soul Healing Energy), LLC. *

I understand

I don't understand

Required

My name below acknowledges that I agree to the terms and conditions set out by this consent form and certify that the above information is true and correct. I agree to pay for any (in person or virtual) soul guidance readings, should I request them. *

Today's Date *

YYYY

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