Pure Heart Wellness Studio – Client Waiver Form

Pure Heart Wellness Studio is proud to be a sanctuary where independent practitioners can share their gifts and support your healing journey. We hope your experience today brings you peace, clarity, and care.

Name

First Name

Last Name

Phone

(###)

###

####

Who will be servicing you?

Other, notes or inquiries.

Waiver Agreement:

I understand that I am receiving services from an independent practitioner operating within Pure Heart Wellness Studio. I acknowledge that Pure Heart Wellness Studio is not liable for the services provided by this practitioner and holds no responsibility for any outcomes related to the session.

I understand