New Patient Intake & Informed Consent

Core Energetics Practice Informed Consent Waiver

I use and practice Core Energetics as well as other somatic therapeutic modalities to healing.

Core Energetics

I understand that Core Energetics neither treats mental disorders nor conducts mental health evaluations.

I understand that if my Core Energetics practitioner detects or suggests that I suffer from a mental disorder or determines that I need to be evaluated for mental health concerns she should refer me to a licensed mental health practitioner.

I fully understand that Core Energetics is not psychotherapy or counseling and that professional referrals will be given if needed.

I certify that if I am currently in therapy or counseling, or otherwise under the care of a mental health professional, that I have consulted with this professional about my working with a Core Energetics practitioner. I further certify that this mental health professional is aware of my decision to begin Core Energetics Coaching.

I understand that Core Energetics is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment and I will not use it in place of any form of psychotherapy.

The Nature of the Core Energetics Relationship

I understand that the purpose of my relationship with my Core Energetics Practitioner is to create, develop, and facilitate my personal, professional and somatic goals.

I understand that the purpose of Core Energetics is to develop and to implement a strategy, plan, and/or program that is designed to achieve those goals through somatic practice.

I understand that Core Energetics is not to be used in lieu of professional advice. I will seek professional guidance for legal, medical, financial, business, spiritual or other matters. I understand that all decisions in these areas are exclusively mine and I acknowledge that my decisions and my actions regarding them are my responsibility.

I am aware that I can choose to discontinue Core Energetics at any time.

I understand that although Core Energetics is a process that may involve several areas of my life, including career and work, finances, health, and personal and professional relationships, deciding how to manage these issues and implement my choices is solely my responsibility.

Records & Confidentiality

I understand that information transmitted by me in this Core Energetics relationship will be kept strictly confidential unless I give explicit, specific permission to release it to specifically designated persons. I understand that the only exception to this confidentiality will occur if the release of personal information is required by law.