Please read and fill out this form prior to your appointment.

If you have any questions you can email info@mediumlisamercier.com Thank you!

Client Acknowledgement & Consent

Lisa Mercier is a certified psychic, medium, & healer. Services provided by Lisa Mercier are not for the purpose of diagnosing, treating, alleviating, mitigating, curing or caring for disease in any way. It is recommended that you seek a licensed professional for any legal, medical, financial, or psychological concerns. Legally it must be noted that all services are for entertainment purposes only.

I Acknowledge:

  • I have read and understand the above guidelines and disclosure about the treatments and techniques offered by Lisa Mercier, as well as her training and education.
  • I have consented to use the services offered by Lisa Mercier, and I agree to be personally responsible for her fees in connection with the services provided.
  • I will not hold Lisa liable for any new or existing medical conditions or personal injury(ies) that may occur while receiving treatment/services in her home/office or our agreed upon service location.
  • I agree to settle any legal disputes through arbitration administered by the American Arbitration Association in Westminster, California at my complete expense. Judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof.

I have read and understand the above disclosure regarding the service(s) I will be receiving from Lisa Mercier. 
This consent form will be valid for one year from the signing/submitting date.

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