Self Exorcism Client Consent
I understand and agree to the following consent, that we (Self Exorcism, DBA of KT Media, Inc., its employees and third-party contractors; herein known as “COMPANY”) do not offer any representations, warranties, or guarantees - verbally or in writing - regarding any results of any kind. All services are for entertainment purposes only.
These services are not intended to diagnose, treat, cure, or prevent any condition, ailment or disease. If I should experience any such issues, I should see my licensed health care provider or other practitioner as determined by my own judgment. I understand that these services are not intended as a substitute for a consultation with a licensed medical professional. I will consult with my own physician or licensed mental health professional regarding the suggestions contained within these services as determined by my own judgment. I understand and agree that I am fully responsible for my mental well-being, mental, and physical choices and decisions during and after the services rendered. The use of these services implies my acceptance all within this service agreement.
The COMPANY is not a licensed healthcare provider and represents that they have no expertise in diagnosing, examining, or treating medical conditions of any kind. I expressly consent to any and all treatments, methods, and techniques necessary that COMPANY may perform in my services as determined by COMPANY. If I engage in any of these services, I agree that I do so at my own risk, are voluntarily participating, and agree to release and discharge the COMPANY from any and all claims or causes of action, known or unknown, arising out of these services.
If I experience any physical/mental pain, issues or discomfort at any point, it is up to me to communicate the discontinuation of the service. If this occurs, the COMPANY will discuss alternate solutions and adjustments. If agreed upon by both parties, the session will continue. If not agreed upon by by either party, discussions of appropriate reimbursement for discontinued services or rescheduling of services will occur.
If I have a possible contagious medical condition, temporary or permanent, I will inform the COMPANY prior to arrival for services. I am willing to reschedule or cancel my services based on the COMPANY's decision.
If I am unable to fulfill my scheduled appointment, I will communicate this to the COMPANY and am willing to reschedule or cancel my services based on the COMPANY's decision.
The COMPANY makes no guarantees concerning my expectations defined within these services, and I accept the risk that results may differ for each individual.
The COMPANY advises I take full responsibility for my safety and know my limits. I am responsible for providing all related and important medical and mental health information. I will keep COMPANY updated as to any changes in my medical and mental health moving forward.
COMPANY will provide you the highest quality of care unbiased of any gifts, compensation, or other benefits received.
After the completion of services, if I am disoriented, too tired or otherwise incapable of driving, I am responsible to contact a driver, other than myself, for another means of transportation, at my own expense.
Once the appointment is created there are no refunds upon cancellation. If I am unable to make my service, I may reschedule or apply the credit to any of our services.
I will provide any and all consent and requested information prior to the appointment, which allows COMPANY to perform the highest quality services and care for me.
Any exceptions in this agreement, must be provided and agreed upon by both parties, prior to service scheduling or where the law requires a different standard. I agree that COMPANY is not responsible for any loss, death, illness, property damage, or bodily injury, caused by my participation in the services - or care following the services, and I expressly waive, discharge, release all liability and hold COMPANY harmless of all such claims.
To the maximum extent permissible under applicable law, COMPANY will not be responsible to me or any third-party claims made by me for any direct, indirect, special or consequential, economic or other damages arising in any way from participation in the services.
I will remain clothed for the duration of services. Prior to the services, I will inform and obtain approval from the COMPANY of any purpose for changing clothes or removing clothes. Any illicit or sexual suggestive comments or actions made by I will result in immediate termination of the services and no refunds or credit will be issued. All incidents will be documented and any appropriate or necessary legal action will be taken.
COMPANY is not required to comply with HIPAA, but does treat video/audio recordings, photographs, images and personal information, as private, and complies with applicable laws which protect the privacy and security of my personal data.
Any additional parties I have invited or will be attending must be approved by me in writing, within the limits of the law.
Any client communication and information exchanged in writing, digitally, or verbally in relation to the session will be treated as confidential and will not be shared, without the client's written consent, within the limits of the law.
All post-service information or recordings obtained by COMPANY during or after services will be delivered to your previously provided email within 5 to 10 business days.
COMPANY does not refuse service to any client based on disability, culture, ethnicity, gender identity, marital status, physical appearance, language, representational system, sexual orientation, political affiliation or socioeconomic status.