Release of Liability, Consent and Agreement
Last updated: March 05, 2020
Release of Liability
I, understand that in order to receive services from Act To Be, LLC Holistic Health, I am required to acknowledge and accept this Release of Liability, and Consent to Receive Treatment. By doing so, I agree to the following for all sessions that I receive now and in the future.
Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Act To Be, LLC Holistic Health, coaches and practitioners, against any and all claims or liability of whatsoever kind or nature arising out of or in connection with the service(s) provided.
I understand that the healer providing service is not a licensed physician and that alternative healing approaches are not licensed. These treatments are meant to compliment Western medical approaches provided by doctors, nurses, and other licensed medical professionals. Complementary healing arts, such as Energy Healing, Reiki and Metaphysical Coaching, do not require licensing.
I understand the theory behind complementary healing arts, such as Energy Healing, Reiki and Metaphysical Coaching sessions and the nature of the services which are explained on the Act To Be, LLC Holistic Health website acttobellc.com with further details acttobellc.com FAQ page.
I have discussed with the healer providing service any concerns I have about the nature of the treatment that she/he will be providing, and if I experience any discomfort during the session(s), I agree to immediately inform her/him.
I understand that complementary healing arts, such as Energy Healing, Reiki and Metaphysical Life Coaching are not a substitute for medical treatment or medications. I am aware that Act To Be, LLC Holistic Health does not diagnose illness or disease nor does prescribe medications or recommend supplements. I understand that any suggestions that are provided to me should not be taken as a diagnosis or recommendation against the advice of a licensed physician or mental health professional.
I have consented to use the services offered by Act To Be, LLC Holistic Health, and I agree to be personally responsible for their fees in connection with the services provided. I agree to make session cancellations by emailing or by leaving a voicemail 24 hours before the scheduled appointment. I understand that if I fail to do so, I am still responsible for the full amount of the fees for that appointment.
I agree that I am at least 18 years old.
I understand that Act To Be, LLC Holistic Health reserves the right to refuse service for any reason.
I acknowledge that I have read this and fully understand that I am automatically consenting to this release of liability by becoming a member, scheduling and paying for any service or plan offered by Act To Be, LLC Holistic Health. I agree to voluntary give up or waive any right that I otherwise to bring any legal action against Act To Be, LLC Holistic Health, coaches and practitioners.
Coaching Consent and Agreement
I acknowledge that by becoming a member, paying for and scheduling any service or plan, I consent to coaching services, provided by the coaches of Act to Be LLC, Holistic Health. Act To Be LLC, Holistic Health coaches hereinafter referred to as “coach”.
I understand that coach is not a licensed mental health professional and does not provide psychotherapy, counseling, or any other mental health service that would require a license, nor does coach hold themselves out to provide such services. Coach provides consulting and educational services that often result in substantial learning and transformation.
I understand the Metaphysical Life coaching offered is based on the field of Neuro-Linguistic Programming, Energy Healing, Law of Attraction and manifestation, coupled with universal spiritual principles and applied teachings.
I agree to be on time for each appointment, conducted on the phone. I understand that if a scheduled appointment begins late due to your failure to be available at the agreed upon start time, the appointment will still terminate at the appointed end time.
I agree to make session cancellations by leaving a voicemail 24 hours before the scheduled appointment. I understand that if they fail to do so, they are still responsible for the full amount of the fees for that appointment.
I understand that the coaching relationship will be for weeks/sessions pre purchased. Sessions are approximately 30 minutes in length unless otherwise specified.
I understand it is both ill-advised and detrimental to the work coach provides to terminate this relationship prior to the agreed duration. If I chooses to discontinue the work, I am still financially responsible for the entire duration of the prepaid purchase term.
I agree to take an active roll in the life coaching process by being absolutely honest with coach and themselves about any feelings or issues I may have around the coaching process, or the coach.
I understand that any and all issues discussed in the context of the coaching process are confidential, and will be treated as such, unless they give their expressed written permission to coach communicating and authorizing otherwise.
I acknowledge that I am completely responsible for my own business, emotional life, actions and the results I am experiencing in my life, and I initiate the coaching process with this in mind.
I understand that I may benefit from Metaphysical Life Coaching, but results cannot be guaranteed or assured.
I agree that I am at least 18 years of age.
I understand that the information disclosed during our conversations are confidential and may not be revealed to anyone without client’s written permission, except where disclosure is required by law. No information about any client will be discussed or shared with any third party without written consent of the client.
I understand that I am automatically consenting by becoming a member, scheduling and paying for any service or plan, with Act To Be, LLC Holistic Health, I am assuming full responsibility for my services and I hold harmless both the coach and Act To Be, LLC Holistic Health who provide the service.
Reiki Consent and Agreement
I acknowledge that by becoming a member, paying for and scheduling any service or plan, I consent to treatment for myself/my minor child/animal , and understand that the services provided by the practitioners of Act to Be LLC, Holistic Health is intended to enhance relaxation and increase communication within my body. I acknowledge I am at least 18 years of age.
I understand that these services are not a substitute for medical treatment or medications. I am aware that diagnosis is not given and medication is not prescribed. I agree to continue to have regular medical check-ups as part of my overall health care plan. I acknowledge that no guarantees have been made to you, the client, from Act to Be LLC, Holistic Health, as to the effect of any Reiki sessions, Reiki Box or distant.
I understand that Reiki treatments have a cumulative benefit. They are supportive of well-being in every way. While Reiki supports wellness for the physical, emotional and mental body, it is not a replacement for licensed medical treatment. Reiki sessions are given for the purpose of stress reduction and relaxation to promote healing. I understand that Reiki can complement any medical or psychological care I may be receiving. I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that the long term imbalances in the body sometimes requires multiple sessions in order to reach the levels of healing need by the body to heal itself. I understand that I may experience ‘healing reactions’ during the 24 to 48 hours following the services provided. For more information on ‘healing reactions’, please refer to the FAQ page.
I understand that any information exchanged during any session is educational in nature and is to be used at my own discretion. I also understand that any information imparted during these sessions is strictly confidential in nature and will not be shared with anyone without my written permission. I do, however, give the practitioner consent to use my case history and results without using my name. I understand that only the practitioners of Act to Be, LLC Holistic Health will have access to information in my file to enhance my healing.
I understand that I am automatically consenting by becoming a member, scheduling and paying for any service or plan, with Act to Be, LLC Holistic Health, I am assuming full responsibility for my services and I hold harmless both the practitioner and Act to Be, LLC Holistic Health who provide the service.
Changes to the Release of Liability, Consent and Agreement
We reserve the right, at Our sole discretion, to modify or replace these Terms at any time. If a revision is material We will make reasonable efforts to provide at least 30 days' notice prior to any new terms taking effect. What constitutes a material change will be determined at Our sole discretion.
By continuing to access or use Our Service after those revisions become effective, You agree to be bound by the revised terms. If You do not agree to the new terms, in whole or in part, please stop using the website and the Service.
If you have any questions about these Terms and Conditions, You can contact us: