Session Preferences & Consent
Welcome to Riverways Craniosacral Therapy! Before your session begins, please take a moment to fill out this form. Your well-being is a top priority, and this information will help ensure that your session is tailored to your specific needs and concerns. Please provide accurate and thorough responses to the following questions, as they will assist in providing you with the best possible care. Thank you!
Cancellation Policy
I understand that life happens and plans can change. If you need to cancel or reschedule your appointment, please notify me at least 24 hours in advance and I'll refund your payment. Cancellations made less than 24 hours before the scheduled time are non-refundable. Thank you for your understanding and cooperation.
Consent for Energy Medicine Sessions
Kristen Dawn, Riverways Craniosacral Therapy
50 Depot St., Collinsville, CT
Contact: Kristen Dawn, kristen@riverways.life
Definition of Energy Medicine
Energy Medicine is a holistic integrative approach intended to clear, balance, and energize the human energy system in order to facilitate physical, emotional, mental, and spiritual self-healing.
The trained practitioner, Kristen Dawn, uses various energy modalities with heart-centered intention. Energy Medicine is intended to complement and not replace any prescribed medical care. Practitioners do not diagnose conditions or prescribe treatment.
Session Information
Sessions are 60 minutes long. The fee per session is $120.
Kristen is not a provider for any insurance carrier and upon request will provide an invoice that the client may submit.
Confidentiality
All client information and records are treated in a confidential manner and no information will be released to anyone without my prior written consent, except in situations governed by law.
Disclosures
· Energy Medicine practitioners do not diagnose conditions or prescribe treatments.
· No specific claims will be made by the practitioner regarding results from the energy sessions.
· Goal(s) for our work together will be mutually identified as part of the assessment and clients have input in the goal-setting process.
Practitioner Liability Insurance
Energy Medicine
Hold Harmless Clause
Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless, Kristen Kerwin, Riverways Craniosacral, from and against any and all claims or liability of whatsoever kind or nature arising out of, or in connection, with my session(s).
Wellness
Session Preferences
Consent and Agreement
I have read this document and been given the opportunity to ask questions regarding this document and Energy Medicine sessions.
I take responsibility to inform my practitioner of any changes in my health status.
Yes, I give permission for light touch.
Cancelation Policy
I understand that life happens and plans can change. If you need to cancel or reschedule your appointment, please notify me at least 24 hours in advance and I'll refund your payment. Cancellations made less than 24 hours before the scheduled time are non-refundable. Thank you for your understanding and cooperation.