Informed Consent

All in-person therapies will receive a hard-copy of the full consent and release form. Those having distance healing are not required to sign but are encouraged to read through and be fully aware of what they are consenting to during treatment, coaching or consultation, and will receive a digital copy upon booking.

 

  • I, Katrina Tschirhart do not diagnose conditions, prescribe medications or provide medical treatments
  • The sole purpose of this session/s is for relaxation or stress reduction, plus also to balance, harmonize, release and heal on all four levels (physical, mental, emotional and spiritual)
  • I understand that some bodily functions may temporarily be affected as a result of shifting energy within my body and I agree that this is a natural occurrence (E.g. release of gas from the rectum) or is non-sexual in nature (E.g. erection in male clients)
  • I assume sole responsibility for my own health and for the results of any sessions provided by Katrina Tschirhart, that may affect my health in any way
  • Treatment/s will not replace conventional medical diagnosis or treatment.  I will continue taking medication prescribed by a licensed medical physician and will continue to follow his/her instructions.
  • I release Katrina Tschirhart, from all legal liability during my participation in any/all treatment/s or that of my child.
  • All information received by me from Katrina Tschirhart is accepted with full knowledge that any action taken by me as a result of the information received is my complete responsibility

 

[] understand the above statement in regards to services offered and give permission to Katrina Tschirhart to perform such services as outlined above (or on the website), and state that I have disclosed any information (health or otherwise) that may alter the effectiveness of services offered.

[] understand that if at any time I feel discomfort or have a problem with the session, it is my responsibility to voice my concerns.


[] understand that Katrina Tschirhart is an independent practitioner, and is still a novice getting her required hours of practicum.  

 

[] understand that Children may not be present unless they are the ones having treatment.

 

[] understand that my phone must be off so that it will not cause distraction or disturbance of energy during a session


[] understand that a deposit is required at time of booking by cash/venmo/paypal/ direct transfer, and remainder of the payment is due at the time of the session;  I must give 12 hours notice, by call, text or email, for cancellations to avoid cancellation fees (50% of booking); Appointments Cancelled at least 12h before appointment may be rescheduled for no additional fee; and at any time during a session I can request to stop session, though this will not entitle me to a refund. In the case of a child client, a partial refund may be given up to 30%, or session rescheduled.

 

FULL FORM HERE

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