Required by State of California Legal Disclaimer
& Entrance Questionnaire, Version 2.2

Dear Recipient of Energy Reality Services,

The State of California requires that alternative practitioners give the following disclaimer in order to practice legally in the State of California. According to state law the following information must be disclosed to you. Please read, and respond entering your name and contact information where indicated below. Your response will be equivalent to a signed agreement.

Then, fill out the following Entrance Questionnaire. And the press SEND.

A copy of this will be sent to you. Thank you.

LEGAL DISCLAIMER Version 2.2: Energy Reality Services are alternative or complementary to healing arts services licensed by the state. Energy Reality Services are not licensed by the state. The author/practitioner of Energy Reality Services is not a medical doctor nor a licensed physician nor a licensed psychologist nor a licensed psychotherapist. Persons with psychological or physical illness that require a medical doctor or psychologist or psychotherapist should contact licensed practitioners. Energetic-Psychotherapy is not to be confused with licensed Psychotherapy. Energetic-Psychotherapy is different in that it is a method of working with energies of consciousness only. The author/practitioner does not recommend the discontinuance of legend drugs or controlled substances prescribed by an appropriately licensed practitioner. Energy Reality Services and Spiritual Healing work with nonphysical body energies, and thus may be unproven according to the FDA and AMA. Therefore, no claims can be made or are made for its effectiveness or use for treating psychological, psychiatric or physical health problems. Energy Reality Services or similar services are not intended to be a substitute for appropriate medical care by a licensed physician or licensed practitioner. Terminology used in this presentation, or by the author, or his assistants, or representatives, in no way corresponds to medically labeled psychological or physical ailments, diseases, dysfunctions, or physical phenomena; and, terminology used only serves as labels for various kinds of nonphysical energy health. Energy Reality Services are of a nonphysical energy and educational nature, only. Energy Reality Services are based upon the theory that nonphysical energy is the basis of reality and that by working with nonphysical energy, reality can be improved. The education, training, experience, and other qualifications of author/practitioner of Energy Reality Services consists of: BA in psychology from UCLA, Doctoral studies in psychology at CIIS, personal study with numerous energy healers and spiritual teachers, training in Psychosynthesis and Regression therapies, extensive personal research and development of the use of nonphysical energies, approximately 29,000 hours of meditation, the full range of samadhi absorptions, intensive practice of Vipassana/insight meditation with absorption in supramundane jhanas and nibbana and consequent fruitions and liberations, the awakening of the divine eye, the awakening of spiritual healing power, nearly the full range of kundalini awakening, direct absorption from Source and divine helpers of higher wisdom, personal recovery of extensive innate knowledge and wisdom, and practice as a healer/counselor and meditation teacher for over 27 years. The author/practitioner is a registered minister and thus is a spiritual healer and spiritual guidance consultant and all healing and guidance that occurs with his work comes from The One Divine Source, recognized by each religion in its own way - God, Source, Tao, Nature, Christ, Bodhisattva, etc. i.e. The One Divine Source. Considering the source of the healing and guidance; I, the undersigned shall give all responsibility for the outcome of the healing and guidance to The One Divine Source. I, the undersigned, take complete responsibility for the effects of any action I choose to take in response to any guidance or consultation given. I, the undersigned, understand that meditation instruction, if given, is an activity which may involve physical, emotional and psychological activity and that in case of such an undertaking there is always a risk involved. I understand that the instructor cannot always monitor my physical, emotional, and psychological limits, and that I am therefore responsible for assessing the risk any activity poses to me, and for choosing a safe course of action for myself. I have been provided with the following information in a written statement using plain language: (A) That he or she is not a licensed physician. (B) That the treatment is alternative or complementary to healing arts services licensed by the state. (C) That the services to be provided are not licensed by the state. (D) The nature of the services to be provided. (E) The theory of treatment upon which the services are based. (F) His or her educational, training, experience, and other qualifications regarding the services to be provided. All Services have a Conditional Money-Back Guarantee, explained as follows: Most people experience profound results in minutes or within the hour with all of the services offered on this site.   However with the first session, if you are not satisfied with any service given by Energy Reality or the practioner, you may refrain from paying at the end and if you paid you may ask for a refund in partial or in full. Requests for a refund must be made within 14 days of payment and be made by email or phone in order to be valid. No refund will be made after the 14 day period. You may however, request a transfer of credit to a different service within 30 days of a service by using the Transfer Credit form. To request a refund you must fill out the Refund Form in order to receive the refund. No refunds with second or later Energy Reality sessions of any kind. Exception: The above policy applies to a session where there is obviously discernible symptoms or life conditions that the client can monitor during the session and give feedback to the spiritual healer and advisor as to the progress made moment by moment. Such feedback is important for rapid and complete healing and resolution because techniques may need to be adjusted for maximum discernible results, and, the reality creation process of the client must be co-facilitated which is guided by discernible results. In other words, regarding this second process, the client's conscious recognition of change and consequent belief in it is a determining factor in having the healing or resolution maintain or be permanent. Therefore; issues and conditions that have no obvious sign or symptom during the session and rely on some future test, exam, or experience must be worked with in usually more than one session all on a nonrefundable basis because the client is partially responsible for the progress and the spiritual healer/advisor is putting in a supernormal degree of effort to affect change that deserves compensation like any other health care and consultation service or more so. Important: Usually people have problems or conditions because a part of themselve's wants to have them. That does not mean that the problems or conditions are valid and actually useful. Therefore it is important that the client not use the promise of a refund and the having of money as any degree of motivation to not get well or not have a resolution. The client must, in their mind and being, commit 100% to the best of their ability to the healing or resolution and to the reporting of recognizable change and relinquish the donation to the spiritual healer/advisor for the greatest empowerment of the spiritual healing/advising process. You must really want the session to work. PLEASE NOTE: Most people notice changes immediately. However, it is important to realize that some people are slow to change in certain areas and may require overnight, 3 days, and sometimes a week to notice changes. In some cases, no changes are noticed by the recipient of the service, but other people notice the changes for them. Therefore, you may want to wait a little while before submitting the refund form or transference form. Also, if you request a refund or transference of credit from a service, it is unlikely that you will be allowed to repeat that service. I, the undersigned, understand the Conditional Money-Back Guarantee and will abide by it. .

Type your name here which is designated as equivalent to your signature:
(entire name, required for services)
Today's Date: (required for services)
Type your email address here (required):
Type your current contact information here so you may be contacted:
Address: City: State/Province: Zip: Country: Phone (home): Phone (other):
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ENTRANCE QUESTIONNAIRE:
(CONFIDENTIAL)

Please answer the following questions so there is more time in the session for healing, etc.
Gender: Age: Exercise and frequency: Describe your diet (ex. Omnivore?, Vegan?, Sugar?): What is your ethnic heritage (for dietary purposes only; ex. Swedish?, East Indian?): Occupation: How you found out about these services:

Due to the high demand for rapid (typically in minutes or seconds) spiritual healing of psychological issues and physical ailments, preference is given 1st to those with the severest conditions (life vs. death, intense pain, or other severe condition) and preference is given 2nd to those that can pay the most. This is because I have a waiting list of people with severe conditions but no or little money and if I served them only I would not be able to pay for my operating expenses and unable to help them at all. I allot as much time as I can to those with severe conditions, a portion to those that pay the most, and a portion to those that can only pay moderately. I try to be fair to all and put those in each category on a waiting list if necessary.
Please rate the severity of your condition on a scale of 0 to 10(being the severest):
Please describe briefly your condition or what you want to work on:

Please describe your ability to pay, per hour session, on a sliding scale of from $100(low income and no savings/assets) to $500(high income and/or high savings/assets):
(Please note: less than 48 hours notice of cancellation will incur a charge of your rate, except in case of emergencies.)
If you cannot pay anything or very little and are requesting charity please indicate this and how much you can pay:
If your are able and want to pay more than the above top rate, so that more people can be healed, please indicate what this will be:
Thank you. And, I very much look forward to helping you.
Healing Light,
Steven Lumiere

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