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Galactic Akashic Reading Intake Form & Consent

Thank you for your interest in booking a Galactic Akashic Reading session with me! It is an honor to guide you through this experience and support you on your journey. 

Please fill out this form for your session. 
All information you share is kept confidential and meant to create a safe, grounded and aligned experience for us both. If you have any questions or concerns, feel free to reach out. 

Have you had a Galactic Akashic Reading before? Required
I certify I am at least 18 years old Required
If I choose to have the session recorded, I agree to not publish the audio recording online or on any social media platforms due to the personal nature of this work. The recording and information remain strictly confidential between the client and practitioner. Required

Service Agreement and Liability Release

**Recitals**

1. The Practitioner is engaged in the practice of spiritual counseling and guidance, including but not limited to Spirit-Guided Remote Spirit Release Therapy, Quantum Hypnosis, Cosmic Quantum Healing, Reiki, Meditation Guidance, Astrological Chart Readings, Energy Healing.

2. The Client desires to engage the services of the Practitioner and agrees to disclose certain confidential personal information for the purpose of receiving spiritual guidance.

3. The Practitioner undertakes to keep all disclosed personal information of the Client confidential, according to the terms of this Agreement.

*Agreement**

1. **Confidential Information**: 
   - "Confidential Information" refers to all oral and written communications provided by the Client, including but not limited to personal, spiritual, financial, and familial information, shared for the purpose of receiving services.
   - Confidential Information shall not include information generally known in the public domain or information independently developed by the Practitioner without reference to or reliance upon the Client's Confidential Information.

2. **Obligation of Confidentiality**:
   - The Practitioner agrees to:
     a. Keep the Client's Confidential Information in strict confidence;
     b. Not disclose the Confidential Information to any third party without the prior written consent of the Client;
     c. Use the Confidential Information solely for the purpose of providing contracted services to the Client.

3. **Exceptions to Confidential Obligations**:
   - Confidential Information does not include information that:
     a. Was publicly known or comes into public domain;
     b. Is received by the Practitioner from a third party without breach of this Agreement;
     c. Is disclosed under operation of law, subpoena, or judicial order. In such cases, the Practitioner agrees to notify the Client promptly and to cooperate fully to seek a protective order or similar protective measures.

4. **Duration of Confidentiality**:
   - The obligation of confidentiality shall remain in effect for [Specify Duration, e.g., 5 years, indefinitely] after the termination or conclusion of this Agreement or until such time the Confidential Information becomes public knowledge otherwise than through breach of this Agreement by the Practitioner.

5. **Return of Materials**:
   - Upon termination of services or at the Client's request, all materials containing Confidential Information, in any format, shall be returned or destroyed as directed by the Client.

6. **No License**:
   - Nothing in this Agreement grants the Practitioner any rights, by license or otherwise, to any of the Client’s intellectual property or personal information except as expressly set forth herein.

7. **Severability**:
   - If any provision of this Agreement is found to be unenforceable or invalid, that provision will be limited or eliminated to the minimum extent necessary so that this Agreement will otherwise remain in full force and effect and enforceable.

8. **Entire Agreement**:
   - This document reflects the entire agreement between the Client and the Practitioner regarding the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral.

9. I understand that Kristy Engelke is not a licensed physician and does not diagnose, cure or prevent any disease and does not practice medicine. She is not a psychologist or counselor and does not treat mental illness or provide personal advice or counseling. All guidance and healing in the sessions is spiritual in nature with the spirit team working with the client’s Higher Self. I am fully responsible for making my own decisions.

10. I understand this modality is not a substitute for medical or psychological advice from a medical or mental health professional. Only a medical professional or mental health professional can provide medical or psychological advice.

​11. I understand that any information or guidance that arise during the session are solely for personal education and entertainment purposes. I understand that any transformation or change is a process and will take time to evolve. Results are not guaranteed.
 
12. I understand I may be given guidance from my Higher Self and Spirit Team/Guides during the session. I understand that the guidance and information comes not from the Galactic Akashic Reader, but from my own higher being and guides.
 
13. I understand that my pracitioner may elect NOT to proceed with the session if she feels it is not in their or your best interest to do so. 
 
14. I understand that our session will be digitally recorded, if clients selects this option. I also understand that in these types of metaphysical sessions, the energy in the room can affect the equipment and recording resulting in static or blank recordings.
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15. â€‹I am willing to be guided through relaxation or stress reduction techniques. I am aware these modalities are non-medical in nature and it is my responsibility to consult my regular doctor about any changes in my condition or changes in my medication.

16. I understand that Kristy Engelke is not a licensed physician; her services are not licensed by the State of California, and that her services are alternative or complementary to the healing arts services that are licensed by the State of California. â€‹
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17. I agree to full release and hold harmless Kristy Engelke from and against any and all claims or liability of any nature arising out of, or in connection with, my sessions.

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​​​​​​​​18. If I choose to have the session recorded, I agree not publish the audio recording online or on any social media platforms due to the personal nature of this work. The recording, my personal information and its findings remain strictly confidential between the client and practitioners.​

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19. I understand once the Galactic Akashic Reading session has been completed, it is nonrefundable. 

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20. I understand because life circumstances may arise and I need to cancel my session, only cancellations done within 24 hours of payment will be refunded with a $10 service fee. 

By signing electronically, I accept the terms and conditions of the Service Agreement and Liability Release and I confirm that my information is accurate and true.

Thanks for submitting!

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