Appointment & Consent

Your Name (First and Last required)

Home Phone Number (required)

Work Phone Number

Cell Phone Number (required)

Your Email (required)

Address

City

State (required)

Zip Code

Country (required)

Your Message

Private channeled readings are offered Monday through Thursday between the hours of 10:00 am and 4:00 pm Central Standard Time. Please let us know the day and time you prefer. We will do our best to accommodate you!

What day of the week do you prefer? (please check all that apply)(required)
Day(s):
 Monday Tuesday Wednesday Thursday

What time of the day do you prefer? (please check all that apply)
Time(s):
 Morning Early Afternoon Late Afternoon

What time zone do you live in?
Time Zone:
 Eastern Central Mountain Pacific
Other:

CONSENT:

I choose to enter into this Agreement with Linda Elwell and Experience Happiness, LLC. (hereafter collectively referred to as EH).

I wish to request and participate in a reading with EH and I do so on a voluntary basis. I am aware that this reading is not a substitute for psychiatric treatment, psychotherapy, counseling or any other form of professional therapy. I voluntarily participate in this reading and accept full responsibility for my own psychological, mental and emotional well-being. I acknowledge it is my responsibility to ascertain my need for professional counseling and to seek it if needed.

By participating in this reading, I, on behalf of my myself, my assigns, heirs, executors, guardians and other legal representatives:
• Release, discharge, waive and forever relinquish EH employees, officers, directors and agents
from any and all claims, known or unknown, connected to my participation and statements made in this reading.
• Agree to under no circumstances prosecute, present claims against or sue EH employees,
officers, directors and agents and to waive all actions, claims or demands that I have now or may have later relative to this reading.
• Shall indemnify and save harmless EH employees, officers, directors and agents in the event that
claims for damages are presented, including costs of defending the same.

I acknowledge and understand that any information provided during this reading shall be considered confidential and not disclosed except as required by law. I have carefully read this Agreement and fully understand its contents, terms and significance. I agree that this Agreement contains a release of liability between myself and EH and I sign this Agreement of my own free will.

*Consent - Please check box if you agree to abide by the terms and conditions listed above: (required)
 Agree