Consent to Receive Services Form

This form MUST be filled out if you would like any Service done. It protects both you and myself.

Name *

Email Address *

Date of Birth: *Please enter your date of birth. MUST be 18 years or older to consent.

State/Country *Please type your State and County of Residence

I Have Read and Understand Terms, Conditions, and Policies: *Before buying any Service please read through Terms, Conditions, and Policies.Yes

I confirm that I am 18 years of age or older: *MUST be 18 years or older to consent.Yes

I understand that the services provided by Hex & Hearth are spiritual in nature: *Yes

I understand that these services are not medical, psychological, legal, or financial treatment: *Yes

I acknowledge that no outcomes, manifestations, or results are guaranteed: *Yes

I understand that spiritual services are subjective and may produce different experiences or results for different individuals: *Yes

I confirm that I am participating voluntarily and of my own free will: *Yes

I acknowledge that I am not being coerced, pressured, or manipulated into receiving services: *Yes

I accept full personal responsibility for my choices, actions, decisions, and interpretations related to these services: *Yes

I understand that these services do not replace professional care, including medical, mental health, legal, or financial services: *Yes

I understand that Hex & Hearth may refuse or terminate services at any time at its discretion: *Yes

I consent to providing a personal photo for spiritual service purposes: *Yes

I understand my photo will be used only for service performance and not shared publicly or used for marketing without my written permission: *Yes

Terms, Conditions, and Policies: *

Consent to Receive Spiritual Services: *

I consent to receive spiritual services from Hex & Hearth.

E-Signature *

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Hex & Hearth

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