You (client) understand that Ed Kuiper is a Licensed Spiritual Healer under the Council of Licensed Spiritual Healers and assists his clients in balancing frequencies that make up their body and their energy systems and releasing negative energy that might be present. You (client) also understand that although phobias are eliminated a majority of the time, Ed Kuiper makes no guarantee regarding the results you may personally obtain. You (client) further understand that using EFT is not a replacement for any professional psycho-therapeutic or counseling sessions in the treatment of any mental health issues or disorders that may be related to your phobia.

You (client) understand that you are responsible for your own well being and that you have the ability to balance the frequencies which make up your body and your energy system and to free yourself of any issues(s) You (client) might have. You (client) also understand that using this ability is not a substitute for adequate medical and psychological care in the event you have mental or physical health issues related to your phobia(s). Therefore, in addition to the services of Ed Kuiper, you intend to use your primary health care provider and/or an appropriate mental health care provider for such issues when you are advised to do so or when You (client) consider it necessary.

You (client) understand your identity and any information about You (client), whether you share it with Ed Kuiper or he discovers it on his own, will be held in strictest confidence except when released by you or specifically required by law. You (client) have the right to waive this confidentiality agreement in whole or part at any time.

You (client) understand that fees are payable in advance by credit card, check or cash prior to services being delivered. In the event you pay by check and it is not honored by your bank, You (client) agree to pay any additional fees incurred for this inconvenience.

Should any disagreement arise between Ed Kuiper and yourself that cannot be mutually resolved, then You (client) agree to professional mediation that both You (client) and Ed Kuiper agree upon.

You (client) acknowledge that you have read and understand this form and you agree to allow Ed Kuiper to assist you in working with frequencies in your body and your energy system to help you balance those frequencies and eliminate the issue(s) You (client) may be experiencing.

Copyright 2018, ‚ÄčEd Kuiper