POLICIES AND PROCEDURES Release and Waiver of Liability, Indemnity, and other agreements/acknowledgments
A. Release and Waiver of Liability, I, for myself, my heirs, next of kin, personal representative and assigns, hereby release, waive, discharge, and covenant not to sue or defame ThetaZones by Jenya Steinberg. Hereinafter, Releasee from all liability, loss, claims, demands, possible cause of action, court cost, attorneys’ fees or other expenses. Including any claim of negligence, that may arise from any loss, damage, or injury (including death) to my person in any way resulting from or arising in connection with, or related to any therapies or modalities performed by any Releasee.
B. Indemnity and hold harmless agreement: I hereby agree to indemnity and hold harmless the Releasees and each of them from any loss, liability, damage, or cost they may incur due to any claim made against any Releasee arising from the provisions of the therapies and modalities to me, or in any way resulting from, arising in connection with, or related to any therapies or modalities performed by any Releasee to me.
C. I understand that the healing work I receive is provided for the basic purpose of self growth and awareness. If I experience any pain or discomfort during the process, I will immediately inform Jenya Steinberg so the session can be adjusted to my level of comfort. I further understand that any healing services provided by ThetaZones by Jenya Steinberg should not be construed as a substitute for medial examination, diagnosis, or treatment.
D. I affirm that I have stated all of my known medical conditions or injuries, and answered all of the questions honestly.
E. I understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session or treatment protocol. I also understand that the licensed Health Practitioner reserves the right to refuse to perform energy/body work on anyone who is deemed to have a condition for which the modality or protocol is contraindicated.
F. I understand that I must take responsibility for my healing and must submit payment at the time of service or membership date. Services are NON-refundable.
Releasee/Client Informational Disclosures: Releasee understands they are required to complete a through assessment and history to insure that all current and prior health matters are addressed accordingly. All information must be answered openly and honestly. Disclosing all health information is better to protect the health and safety of the Releasee/client, as well as the Health Care Provider. This information must be kept on file to maintain licensing, records, and insurance information. No Exceptions. All information shared prior, during and post sessions is always kept confidential and is always HIPPA Compliant. Information will never be exchanged with any third party, without permission of the releasee/client. This information is not intended to cure, diagnose, or treat medical conditions, nor is it a substitute for medical advice. Please consult with a physician before beginning this or any other new healthcare/healing program. Any information with regard to personal testimonies about ThetaZones by Jenya Steinberg is voluntarily written by the clients.
