Anisha Kerry, Soul Support Psychic Medium & Certified Hypnotist
Thank you for scheduling a reading with me. I look forward to working with you. If your reading is in person, my office is located at 750 Warm Springs Ave, Suite A3 (see map below). If your reading is by phone, I will call you at our scheduled time. Please fill out your information below and read and confirm the liability release on the next page.

I will also add you to my newsletter list. Please let me know if you don’t want to receive my newsletter updates.

Thank you!

Email address *
Name (First & Last) *
Your answer
Phone number *
Your answer
Date of First Reading
MM
/
DD
/
YYYY
Information about your reading

In addition to this form, you will also receive an email invoice for the cost of your reading. Please pay this invoice online within four days of receiving it. Your payment holds your appointment slot. If your payment is not received within two days, I will send you a reminder. If it is not paid 24 hours after the reminder, your appointment slot may be offered to another client on my waiting list.

With a notice of seven days, you may cancel your appointment with a refund of the cost of your reading minus processing fees. You may cancel a group reading with full refund minus processing fees and the amount of your deposit, with a fourteen day notice. With a cancellation less than seven days before your reading, you may reschedule your reading, however, a refund will not be given.

I do understand that emergencies and the unexpected happen. Please contact me as soon as possible in order to reschedule your appointment and to give someone else your appointment slot.

Thank you for refraining from wearing heavily scented products the day of your reading.

You are welcome to and encouraged to record your reading or to take notes.

To learn more about how to prepare for your reading and suggestions to best process your reading afterwards, visit the "readings" page on my web-site, www.kerryr.com

My Office - 750 Warm Springs Ave, Suite A3
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service