Fact Sheet and Release Form

I wish to consult Mani Pureheart for Spiritual Healing and/or Psychic Counseling.

I understand and agree to the following:
  1. I understand that Mani has no medical or psychiatric training whatsoever and that anything that he may say to me that could be construed as a diagnosis or a prescription is nothing more than the result of a psychic impression on his part and may or may not have a basis in fact. I agree to explore these impressions with the appropriate medical professional(s) before acting on them.

  2. I understand and agree that I am not compensating Mani for services rendered, but for his time alone. I understand that his time is valued at $60 per 15 minute increment. While this is the suggested value, I also understand that Mani has a very liberal sliding scale available for those in need. The client ultimately will determine the value of the work received and, based on that value, their financial condition and their desire to support Mani and his work in the world, decide whether and how much to donate.

  3. I understand that any work done by Mani falls under the heading of "miraculous" healing. As such, it is clear and plain that Mani has absolutely no control nor responsibility for what happens to my health or well being; when or if the healing happens; how effective it may seem to me or others or how long it will remain with me. I also understand that in rare instances a 'healing crisis' may occur during which time my health may seriously deteriorate before improving. I freely accept all of these parameters.

  4. When engaging Mani for consultation regarding personal and/or family matters, I agree not to accept Mani's word as final authority on any subject; but to simply consider it additional input and information from which to draw my own decisions and actions, for which I accept full responsibility.

  5. Should the occasion arise that I do not feel comfortable with any statement or procedure while Mani is working with me, I understand that I am strongly encouraged to speak out immediately. I understand that I only need to say "STOP" loudly and clearly and all activities will immediately cease until I declare my comfort has returned by stating that is the case.
I certify that I am of legal age and have read, understand and agree to the above statements and conditions.