Consent Form

Hey there! My name is Chrisnelle Joie Peralta-Young and I am a healer, essential oil leader, intuitive spiritual advisor, and RYEE® Angel & Tarot Practitioner. My practice focuses on helping you to transform your mind, body, and soul and feel empowered. I do not diagnose or treat disease and I am not a physician. These sessions are not a substitute for diagnosis or treatment from a qualified health practitioner for illnesses, injuries, or other medical conditions. My services are not licensed by the state of Florida and my practice is guided by integrity.

Basic Definition of Card Reading and Energy Healing

Tarot and Oracle card decks are divination tools used to help explore many areas in one’s life. They are used to help connect to God/Source/The Universe/The Divine/Spirit/Higher Self (my views are that they are all connected lean into what feels right for you – I use “Spirit” for simplification) for messages that only they can deliver. I AM NOT A FORTUNE TELLER AND DO NOT PROPHESIZE. It is not used to predict the future as we have Free Will, and due to our free will, timelines change frequently. It is strictly a predictive tool that contains guidance from Spirit that can help support life decisions and lessons. “Balance is at the core of tarot and makes  it the perfect tool for people seeking wholeness.” I use Tarot more intuitively and Oracle cards to support, reading pretty straight forward from the card itself.

Energy healing addresses ailments that may be associated with our spiritual, physical, and emotional being. I tap into the energetic field of the individual, and depending on what shows up, use a certain healing modality to help get the energy unstuck and flowing. This clearing of energy blocks has been proven in many instances to help enhance one’s healing journey.

Description of a Session

During a session (which can vary in length averaging thirty to sixty minutes), I will use tools such as Tarot cards, Oracle cards, meditation, essential oils, chanting, music, or energy work. With energy work, I will gently place my hands on or above the person’s fully clothed body noting any sensations or imbalances to assess the energy field. I then choose a healing modality/technique that is appropriate for your needs. This may include light physical touch or sweeping hand motion above the body. This may also include the application or diffusion of essential oils. There is a high likelihood that you will experience the relaxation response during the session. A feedback discussion will follow. People have many different responses to an energy clearing session. Some clients feel nothing at all. Others describe sensations of moving energy, deep relaxation, feelings of being supported and nurtured, or visions of images and colors. Some patients experience an emotional release such as tears; some have what they consider to be a spiritual experience or they may develop insight into specific areas of their lives.

My Energy/ Educational, Training and Experience

RYEE® Angel & Tarot Practitioner Certification, Chanting & Mantras

Confidentiality/Client Rights

Your experiences during our sessions are confidential, and you have a right to view your files upon written request. Confidentiality is subject to the following exceptions:

  1. You may instruct me to release information to other health care practitioners in writing.
  2. I may release information if subpoenaed or otherwise legally obligated or reasonable allowed to do so (including circumstances where there is a clear and imminent danger to yourself or another person).
  3. Your confidential personal file is kept in a secure location and is retained for 4 years after you suspend services after which time all information will be destroyed in a proper manner.
  4. Your confidentiality is always subject to the usual exclusions dictated by state and federal laws and regulations.

ACKNOWLEDGMENT, CONSENT, CLIENT PRIVACY RIGHTS

I have read and understand the above disclosure regarding the services offered by Chrisnelle Joie Peralta-Young.

We have discussed the nature of the services to be provided including information that the healing/energy session is not religion specific and is a holistic complementary and integrative energy-based modality that is accomplished through the use of contact and/or non-contact touch. I understand that she is not a licensed physician and that her services are not licensed by the state of Florida. I understand that it is my responsibility to maintain a relationship for myself with a medical doctor if I so desire. I further understand that the above named is not trained to diagnose illness, make recommendations involving pharmaceutical drugs or surgery, or handle medical emergencies.

I have read and understood the above disclosure regarding privacy policies and confidentiality, and that experiences during these sessions are confidential but subject to the usual exceptions governed by laws of the State of Florida and other federal laws and regulations.

Except in the case of gross negligence or malpractice, I or my representative(s) agree to full release and hold harmless Chrisnelle Joie Peralta-Young from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).

I have been informed that my Healing Arts Practitioner will neither diagnose nor prescribe for any condition that I might have nor does she make any specific claims regarding results from the sessions that I receive.

My questions have been answered to my satisfaction regarding my provider’s background, what the session entails, and what I might expect from this session.

I fully consent to use the services offered by Chrisnelle Joie Peralta-Young by signing below:

SIGNED:____________________________________________  DATE:______________

PRINT NAME:____________________________________________________________

ADDRESS:_______________________________________________________________