CLIENT CONFIDENTIALITY/and INFORMED CONSENT

1. I fully understand that Stephanie Shipper is not an M.D., psychologist, MSW, but is a Certified NLP Trainer, Certified Hypnotherapist,  Trained in Kinesiology (Touch for Health,) and Certified in Thought Field Therapy.  I am not here for any medical, diagnostic, treatment or therapeutic procedures.  All services performed by Stephanie Shipper are restricted to education/coaching/mentoring._______
   
   
2. I fully understand that Stephanie Shipper does not Treat, Diagnose, Hospitalize or Prescribe drugs/ remedies for diseases,  nor does she do any services which require a license in this state.  I understand if I need these services I am advised to seek them from properly licensed practitioners.  In no circumstances am I advised to discontinue or ignore treatment or advice from licensed professionals.________
   
   
3. I understand and accept that all suggestions, information, and or education by means of discussion,  muscle testing,  or other means is purely educational and in no way constitutes a medical diagnosis or treatment._______
   
   
4. I understand that I am the person most responsible for my own health or well being.  Should I be uncomfortable with any suggestions made,  I am free to disagree and refuse suggestions and seek a better solution from within my own frame of reference._____
   
   
5. I have solicited Stephanie Shipper’s advice in good faith,  exercising my free will and following the dictates of my own conscience,  which allows me to select what I understand is most beneficial to my health.______
   
   
6. I fully understand that if I am under the care of medical or mental health licensed professionals for the same or related problem,  and I am on a prescribed medication/medications for this problem,  Stephanie will seek a referral for services from that medical or mental health professional before beginning services._______
   
   
7. In the case of #6,  I agree to shared information from my M.D.,  or therapist/psychologist for the purpose of appropriate integration of services.______
   
   
8. I,  the undersigned state that I am under the care of my own personal physician and therapist/psychologist in all matters pertaining to and affecting my health._____
   
   
9. If I desire services not provided by Stephanie,  which is my prerogative,  I fully understand that I am free to seek them elsewhere.  Stephanie may be called upon for reliable referrals.______
   
   
10.  I understand that it is common to experience fatigue,  and/or greater need to rest after treatment.  It is sometimes common to experience a full range of emotions in the days after treatment.  I agree to set aside the time to allow rest and assimilation of my experience.______
    
    
11.  I fully understand that the services provided by Stephanie are not generally accepted or recommended by medical doctors or other conventional health professionals.______