Informed Consent

INTUITIVE ENERGY WORK
Thank you for considering working with Kristin Moen at 5DWorks LLC. This document contains important information about Kristin Moen and what you can expect during our sessions. Please read it carefully and ask any questions you might have. If you decide to proceed and sign this document /schedule a service with Kristin, it will represent a formal agreement between us.

WHAT IS INTUITIVE ENERGY WORK?
Intuitive Energy Work is an approach that involves balancing and restoring your body’s natural subtle energies and working with mental and emotional energies to raise your overall frequency for the purposes of increasing your vitality, strengthening your mental capacities, and optimizing your overall wellbeing. 

KNOWLEDGE AND EXPERIENCE

Kristin is an Intuitive Coach, Artist, Teacher, Former Educational Leader and Channeler. 

Kristin began by channeling information and energy into her artwork and now is helping others become more aware of their own subtle energies, placement of energy, and provides tools to help others align and raise their vibrational energy. She has studied energy work for many years and worked in public education for 24 years. Her goal is to empower others to take charge of their own energy work and energy healing through intuitive coaching.

OUR WORK TOGEtHER
You can expect Kristin to approach her work with you in a professional manner, to honor scheduled appointment times, and to treat information she learns about you as confidential.*
Intuitive Energy Work techniques bring disturbed energies back to a state of balance and harmony. If you are uncomfortable with any of the procedures being used, please tell Kristin immediately and she will instantly stop. If anything changes from session to session it is your responsibility to inform Kristin.
While the methods Kristin will be using are gentle and considered non-invasive, it is possible that physical or emotional after-effects may occur after your energies have been stimulated and adjusted. In some instances, deeper pressure is used to move energies that may be blocked or congested in a particular area of the body, and this may cause some pain or discomfort. Dizziness, nausea, or anxiety are relatively unusual but not unheard-of side-effects to energy work. If any procedure is uncomfortable or leads to discomfort, please tell Kristin immediately. She will instantly stop if you request her to do so.

OTHER ASPECTS OF OUR RELATIONSHIP
Questions. Please ask Kristin questions about anything that happens in your work together. She is always willing to discuss the how and why she does something.
Communication: You are always in control of your session whether or not it's completed via remote options, or in person. You are obligated to communicate with Kristin your concerns, discomforts & needs. If you are ever uncomfortable with any aspect of your Energy Work you are obligated to inform Kristin immediately.

PERSONAL RESPONSIBILITY OF CHOICE
Your scheduling of services indicates that you have read the information in this document, understand it fully, and have discussed any questions or matters of concern with Kristin Moen.
By signing/ scheduling a service with Kristin, you agree that we have disclosed to you, sufficient information to enable you to decide to undergo or forgo the services offered. You have considered the aforementioned information. You have obtained whatever information or professional advice you deem necessary to make an informed decision.

RISK AND RESPONSIBILITY
By signing this document / scheduling a service with Kristin, you understand she is offering her services solely as a supplemental option. Your relationship is not to be construed as or a substitute for medical treatment, psychotherapy, psychological counseling, or any type of therapy. Due to experimental, supplemental and alternative nature of intuitive methods, you agree to assume and accept full responsibility for any and all risks associated. You understand it is your responsibility to maintain a relationship with a health care professional. Further, you understand your consent to the nature of our sessions is given voluntarily, without coercion, and may be withdrawn at any time in the future. You represent that you are competent and able to understand the nature and consequences of the proposed sessions and agree to be personally responsible for the fees related thereto. You have discussed with Kristin the nature of the services to be provided and you understand that she is not a licensed, registered, or certified health care provider in the State of Wisconsin. You agree and understand that this agreement is intended to be a complete unconditional release of liability and assumption of risk to the greatest extent permitted by law.

Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Kristin Moen and 5DWorks LLC from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with these session(s).

By scheduling a service or signing in the space provided below, you knowingly, voluntarily, and intelligently assume these risks and risks and agree to irrevocably release, indemnify, hold harmless and defend 5DWorks LLC, Kristin Moen and her agents, representatives, consultants, and employees from and against any and all claims of whatsoever kind or nature, and for any loss, damage, or injury, including but not limited to, financial, personal, emotional, psychological, medical, or otherwise which you may incur arising at any time out of on in connection with your sessions. If you are submitting this Agreement electronically, typing your name in the space provided below will be considered your signature and constitute your acceptance and agreement thereto.

I have read and agree to the terms above *

First and Last Name *