Middle Name:

*Last Name:

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Evening Phone:

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Best time to call( If Necessary):

If you are currently under the care of a psychologist or doctor, do you have their approval for this session?

Are you currently being treated for any medical or psychological conditions that the Lauri Moore should be aware of before your session?

If Yes Please Explain.

By my signature below, I,
, voluntarily agree to be the subject of a Spiritual Reading. I accept full and total responsibility for any and all injury arising from the Spiritual Reading. I shall hold harmless all parties involved in the Spiritual Reading session. I understand that my session is conducted by someone who is NOT a psychologist, a medical doctor or a minister. I understand that at no time during my session will I be provided with medical or mental health therapy. I confirm that the Spiritual Reading session does not conflict with any existing psychiatric or medical treatment. It is recommended that all advice from any medical or psychological practitioner should be followed. As all things in life, the future is unclear and unknown. Therefore, this authoress will not guarantee the certainty of any premonitions, predictions or opinions regarding the occurrences of future happenings. Prepayment is required for any and all Spiritual Reading session(s). Lauri Moore has the right to refuse any customer.