Register for Group Clearing of Emotional Patterns with Essential Oils

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Memo of Understanding

In consideration of receiving services rendered by Susan D. Ulfelder, I hereby declare as follows:
- That my true and legal name is as signed below and not otherwise.
- That Susan D. Ulfelder has informed me that she is not a medical doctor and I am aware that she is not licensed under the laws of this State to practice any form of medicine.
- That I understand that Susan D. Ulfelder evaluates the human energy field and balances it and that this is not a substitute for medical treatment.
- That I understand that she will neither diagnose nor prescribe for any condition or problem from which I may appear to be suffering.
- That she has suggested, should I have any physical or mental complaints, I should consult a licensed medical practitioner.
- That she has informed me and I understand that no guarantees or promises of cures have or will be made to me and that any benefits which I experience come from within myself.
- That I am 21 years of age or older.
Agreement*
By checking this box indicates that I have read, understood and agreed to the terms of this informed consent and release form. I willingly agree to hold harmless and release from all liability the facilitators, organizers, and participants in this workshop.

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Memo of Understanding