I acknowledge that I am a client by booking a healing through the UOS Student Healing Clinic, and I consent to experiencing one or more Sufi Prophetic Healing Sessions conducted by students at the University of Sufism.

I understand that my student healer receives ongoing training and mentoring from the Clinic Director, but the sessions are not recorded or directly supervised.

I understand there is no medical or psychiatric supervision at this Clinic.

I understand that the Student Clinic healers are not authorized to make medical diagnoses or provide medical, psychological or addiction rehabilitation treatment. I understand that the medical profession does not recognize or approve of spiritual healing. Further I recognize that it is my responsibility to continue to see, consult with, and follow the advice of my regular medical doctors or health-care professionals.

I understand that deep healing work may uncover hidden or unconscious personal issues. I understand that I am fully responsible for myself and my actions at all times. If I am unwilling to address any particular issue, it is my responsibility to inform the Student Healer. The Student Healer is not responsible for any failure on my part to notify him/her of my personal feelings or issues.

I understand that the Sufi tradition holds that God is the Healer and the healer is only a facilitator. This field has not been studied scientifically. I acknowledge that no guarantee of improvements or changes in my medical or psychological condition have has been promised, or implied or guaranteed. I certify to the best of my knowledge that I have no medical or psychological conditions that prohibit me from participating in this program or put me at significant risk. I have agree to submitted a description of my relevant medical and psychological history, including prescription medications and mind-altering substances.

By submitting the following form, I hereby release the Student Healer and UOS from any legal responsibility for any real or imagined changes in my condition.