|
|
|

CONTRACT
The following contract is entered into by and between the Client
who selects "I agree" and JENNIFER KATZ, Brennan Healing Science
Practitioner®, (hereafter referred to as Practitioner) on the
date and time "I agree" is selected.
Client and Practitioner hereby agree as follows:
1) VOLUNTARY AGREEMENTS and CONSIDERATION
I, THE CLIENT AGREE:
a) To call on time for all appointments.
b) To PHONE Practitioner at least 24 hours in advance of any appointment
I need to miss, cancel, or reschedule.
c) Any session I miss, cancel, or reschedule without 24 hours notice
will be lost, without reimbursement.
d) If I am more than 15 minutes late for an appointment, that session
may be lost, without reimbursement.
I, THE PRACTITIONER AGREE TO:
a) Be ready by the phone, on time, for all appointments.
b) Give Client at least 24 hours notice for any appointment I need
to miss, cancel, or reschedule
c) Guard the Client's confidentiality by holding the content of
his or her sessions and records in a strictly professional manner.
2) DISCLOSURE
Limitations I am not a licensed physician, therefore I do not practice
medicine. I do not medically diagnose, treat, or prescribe. I am
not a licensed mental health provider, therefore I do not render
psychological services. I do not advise my clients to discontinue
any medical or psychological treatment they may be receiving. Brennan
Healing Science® is intended to complement traditional medical
and/or psychological care, not replace it. For legal reasons I make
no medical claim as to the efficacy of these sessions. At all times,
your health and well being is your responsibility.
Methods I may use Energy Balancing, CranioSacral Therapy, Nondenominational
Ministry, and/or Brennan Healing Science® techniques in our
sessions.
Fees
Fees may increase annually. Fees are due in advance of each session.
When The Package of sessions has been pre-purchased, the number
of minutes used per session will be subtracted from the balance
at the end of each session. Client's new account balance will be
calculated at that time, and will be reported to Client upon request.
Any fees paid in advance for session-minutes that are missed, canceled,
rescheduled without 24 hours notice, or not met 15 minutes after
scheduled time, will be forfeited.
3) ACKNOWLEDGMENT, CONSENT FOR TREATMENT, and RELEASE
I, the Client, hereby acknowledge that I have read the foregoing
sections "Voluntary Agreements and Consideration", and "Disclosure",
that I am satisfied that I fully understand the nature of the sessions,
and that I freely elect to receive the same. I release and discharge
JENNIFER KATZ, her executors, administrators, associates, partners,
heirs, and assignees from any and all claims of malpractice, non-
disclosure, or lack of informed consent; damages, demands, or actions
whatsoever in any manner arising from or growing out of my participation
in these sessions. I freely assume any risks of the treatment whether
presently contemplated or later discovered.
By clicking "I agree" below the Client indicates their understanding
of and agreement to the terms and conditions of the entire above
stated CONTRACT.
Align your life with the vision of your soul.
|
|