For phone sessions please print 
                                and fill out form below.

                        Send to:        Prema Shanti Runk
                                            P.O. Box 534
                                            Lyons, CO 80540

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Disclaimer

Corrections done by Prema Shanti Runk with Prime Health Energetics, using the Yuen Method of Chinese Energetics are not a replacement for any treatment, and may or my not accelerate the elimination of your ailments.  No claims are made with the use of these methods, of treatment or cures for your conditions, symptoms, injuries, illness or disease. Consult your physician, therapist or counselor for diagnosis and treatment.

As the Participant I hereby release Prema Shanti Runk, Prime Health Energetics, and associates of the Yuen Method of Chinese Energetics from any liability, including personal injury, accident, or any physical, mental or emotional condition that may result from corrections done on Me.

I have read the above agreements and terms and further certify that I am a voluntary participant of all of the above energetic corrections.

print name    _____________________________

address        _______________________________________________________

sign name     _____________________________            date    ___/____/20___

email:    ___________________@_____________________________________

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Prime Health Energetics™