Healing Disclaimer Form
Disclaimer Form for Luna and Flor
Client Name: ______________________________
Date of Session: ______________________________
I, the undersigned, acknowledge and agree to the following terms and conditions before participating in energy healing sessions, consultations, workshops, or any related services provided by Luna and Flor:
1. Nature of Energy Healing, Chromatherapy, and / or Lithotherapy
I understand that energy healing is considered an alternative or complementary therapy. It is not a replacement for conventional medical or psychological treatment, and it does not guarantee any specific outcomes or results.
2. Voluntary Participation
I voluntarily choose to participate in energy healing sessions and related services offered by the Practitioner and understand that the Practitioner is not a licensed medical or psychological professional.
I acknowledge that the Practitioner will keep all information disclosed during the session confidential, except as required by law or ethical standards. However, I understand that energy healing may involve discussing personal experiences and emotions.
The practitioner may use examples from healing sessions without revealing clues or names of the client. E.g. "I once had a client to experience x and y during a session, and repeat this patten on several following sessions. From here we were able to resolve the issue and help the client to move on."
4. Release of Liability
I release and discharge the Practitioner from any claims, demands, or causes of action arising from my participation in energy healing sessions. I understand that the Practitioner is not responsible for any adverse effects or consequences resulting from the sessions.
5. Personal Responsibility
I acknowledge that my participation in energy healing sessions is my choice, and I am solely responsible for my physical, emotional, and mental well-being. I agree to disclose any relevant medical or psychological conditions to the Practitioner.
6. Informed Consent
I have had the opportunity to ask questions and seek clarification about the nature of energy healing and the services provided. I have provided informed consent to participate in these sessions.
7. No Guarantees
I understand that the Practitioner cannot guarantee any specific results or outcomes from the energy healing sessions, and individual experiences may vary.
8. Consultation with Medical or Mental Health Professionals
I acknowledge that it is advisable to consult with a qualified medical or mental health professional for any physical or psychological health concerns. Energy healing is not a substitute for such professional care.
If the client is a minor, a parent or legal guardian must provide consent and accompany the minor during the sessions.
I have read and understood this disclaimer form and agree to its terms voluntarily.
Client's Signature: ______________________________