RELEASE AND CONFIDENTIALITYAGREEMENT

Heather Healing & Heather Swift

I, _________________________________, enter into this Agreement with Heather Swift; Heather Healing to confirm in this Agreement the conditions of my participation in the reading and/or energy session to be performed by Heather Swift. I have been made aware that the 60 minute session is Pre-Paid. Cost is $185.00 for one person for 60 minutes. I have also been made aware that there is a 24-hour cancellation fee with payment due in full, if I cancel my appointment and do not reschedule within a one week period. I acknowledge that I have voluntarily agreed to participate and have requested Heather Swift of Heather Healing to perform this reading and/or energy session. I acknowledge that Heather Swift of Heather Healing is not a Psychologist, Psychotherapist, Psychiatrist, Licensed Mental Health Counselor or Medical Doctor. I am aware that my participation in this reading and/or energy session is not a substitute for psychiatric treatment, psychotherapy, therapeutic counseling or any other form of professional therapy. I , _________________________________ am voluntarily participating in this reading/healing and I accept complete responsibility for my own psychological, mental, emotional and spiritual well being. I acknowledge that it is my responsibility to ascertain my own need for professional counseling and to seek such professional counseling, if needed. I also understand that if any information is given during my reading that may pertain to medical and/or mental health, this is not a declaration of fact being made by Heather Swift of Heather Healing, but only an impression Heather is receiving at the given time. I further acknowledge and understand that any information provided during this reading or any other statements made during same shall be considered confidential and shall not be disclosed except as required by law. I have carefully read this Agreement and fully understand its contents, terms and significance and understand the legal consequences of signing this Agreement. I am aware that this Agreement contains a release of liability and a contract between myself and Heather Swift ; Heather Healing and I sign this Agreement of my own free will. Please print, sign and return prior to your session: Heather@HeatherHealing.com 140 Mayhew Way Ste. 1003 Pleasant Hill, CA. 94523 Dated: ______________________ Signed: ________________________________ Full Printed Name:___________________________ Email:__________________________________