Release Form

ENERGY HEALS, LLC

Body & Mind

RELEASE FORM

My Status and Scope of Practice

My name is Jim Komar and I am a Master Energy Healer, Medical Intuitive and Psychic Medium. The work that I do is a gentle, complementary energy based approach to health and healing that can assist in restoring balance, which can promote the body’s natural healing ability. As a Medical Intuitive, I do not diagnose illnesses and I am not a physician.

The energy healing 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 Colorado.

Basic Definition of Energy Healing

Energy healing is a process where I consciously use my hands to activate acupressure points, meridians and chakras in a heart centered and intentional way to support and facilitate physical, mental, emotional and spiritual health and healing. It is a non-invasive modality that has no known detrimental side effects and can be provided in-person or remotely.

Description of an Energy Healing Session with Jim Komar

An initial consultation and inquiry interview is conducted to discuss your specific health challenges. The In-Person Energy Healing Session is conducted with the client lying supine on a massage table, fully clothed and covered with a sheet or blanket. At times during the session the practitioner may lightly touch acupressure points, meridians or energy centers on the body, but never touching sensitive or private areas.

A Remote Energy session is conducted in the same manner as an In-Person session except the practitioner is in one location and the client is in another. In this session the client receives the energy in the comfort of their private space and communicates with the Jim Komar via telephone.

Acknowledgement and Consent

I have read and understand the above disclosures regarding the services offered by Jim Komar and give full consent to use the services offered by signing below. No guarantee is being made for any condition that I may have nor is there a specific claim regarding results from the Energy Healing session and hereby release Jim Komar and Energy Heals, LLC from any claim for damages.