Dr. Ariana Geoffrey Stahlka
MULTI-BODY ENERGY RELEASE
DISCLAIMER
This session does not take the place of medical or psychological advice from a licensed medical professional, psychotherapist or other licensed healthcare provider.
This session is not a replacement for medical care, diagnosis, prescription, therapy, counseling or treatment of any kind.
I am not a licensed medical doctor a psychologist or a nutritionist.
Please check with your licensed health care provider before making any changes.
CONSENT
Multi-Body Energy Release is an energetic clearing of blocked, unwanted, or trapped energies held within a person’s bodies. The practitioner uses enhanced perception and skill gained through the development of the human senses, including intuition. Multi-Body Energy Release is considered part of an emerging field of energy medicine. Multi-Body Energy Release is not meant to diagnose or treat medical problems or mental health disorders and do not replace the services of licensed healthcare professionals. Although energy medicine uses the term “medicine”, it is not to be construed that the use of Multi-Body Energy Release is the practice of medicine.
Although Multi-Body Energy Release does appear to have promising mental, emotional, spiritual and physical health benefits treatments have yet to be fully researched by the western academic medical and psychological communities and therefore are considered experimental. The practice of Multi-Body Energy Release is self-regulated and considered an alternative or complementary method in the United States since risks and benefits are not fully known, you agree to assume and accept full responsibility for any and all risks associated with participating in this session and using Multi-Body Energy Release.
You represent that you are competent and able to understand the nature and consequences of participating in the session. Further, you warrant the representation and represent that you do not have any medical or psychological condition that would preclude you from participating in the session. You also represent that you are an adult under the laws of the state of your residence and that you have the right to enter into this agreement. In addition, you understand and agree that the session is only for you and not a third party including a minor or an animal.
By signing this document, you grant me permission to conduct and potentially record an audio recording of this session. By signing this document, you grant to me permission to conduct the session, and you agree to fully release and hold me harmless from and against any and all claims or liability of whatsoever kind or nature which you might incur as a result of your voluntary decision to participate in the session. Dr. Ariana Geoffrey Stahlka, Energy Center, Inc. and its owners, officers, employees, agents, representatives, consultants, independent contractors, volunteers, successors, assigns, and others associated with Energy Center, Inc. are held harmless from any and all claims of liability of whatsoever kind or nature which you might incur as a result of your voluntary decision to participate in this session.
I have read, understand and agree to the above disclaimer and consent. Typing my name in the space provided will be considered my signature and constitute my acceptance and agreement of this disclaimer and consent. This agreement becomes effective on the date sign below.
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