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Consent Form

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.  

Please fill out the following form which is required prior to your treatment session.

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I understand that my energy healing session practiced by the practitioner is not a substitute for medical care. You should consult your physician or other health care professional for any medical advice. This information is not intended as medical advice and should not be used for medical diagnosis or treatment.
I understand that my practitioner makes no claims as to recovery from any illness I present now, nor the prevention of any illness I present in the future. I understand that if I have health concerns, I am recommended to seek advice from a medical physician before making any decisions about my health, and that this information is offered as a service and is not meant to replace medical treatment.
I understand that The Emotion & Body Code as taught by Dr. Bradley Nelson, (hereinafter called "energy healing" or "releasing trapped emotions" or "methods") as practiced by the practitioner, seek to identify and eliminate underlying imbalances by releasing trapped emotions, energetic imbalances, promoting harmony and balance within, relieving stress, supporting the body's natural ability to heal.
I understand that these sessions are confidential, and that any personal information would be used anonymously for educational and research purposes only. I understand that I am advised to be self-informed about this work by visiting Dr. Bradley Nelson's website: www.healerslibrary.com and/or by reading his book The Emotion Code.

Thanks for submitting!

EMOTION HEALING SD​

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