Name *

First Name

Last Name

Phone *

(###)

###

####

Have you or anyone else done work towards this goal? *

Yes

No

Is this your first time hiring someone for spellwork? *

Yes

No

Medical Acknowledgement *

I understand that any services provided are not to be used in place of medical advice. Products, services, personal advice, etc. should not be used in lieu of seeking professional help. I understand that Chaotic Fox and Co. may discontinue services if I refuse to seek professional help if deemed appropriate.

Yes

Results Acknowledgement *

I understand that these services are subject to the ebb and flow of the universe and that no outcome can be guaranteed. I understand that Chaotic Fox and Co will readdress any situation if the results are not favorable, but can not be held responsible or liable for a poor outcome. The universe knows what is best for me.

Yes

Divinatory Acknowledgement *

I give Chaotic Fox and Co. permission to consult the forces that be on my behalf to understand my situation on a deeper level and to communicate with my spirit team in order to determine the best route of work. This consent is immediately revoked upon completion of our working relationship. The end of the working relationship will be indicated in an email from CFAC or myself. (Normally, this will be included in an exit survey / form. If at any point you feel that it would be better to rescind this consent or end our working relationship, please let us know as soon as possible.)

Yes