New Client Release Form
My goal is to provide a safe, sacred and comfortable space for the possibility of true healing through mind, body and spirit. As an independent practitioner I offer services to teach, coach, and counsel in order to empower the individual for their highest good and healing.
POLICIES AND PROCEDURE:
Medical Health Conditions: Wellness, Life, Spiritual coaching/counseling, intuitive readings, and Reiki are not a substitute for medical treatment and it is recommended that you work concurrently with a physician or primary caregiver for any health conditions.
Client Confidentiality: All information shared in any type of session is considered confidential and private. Exceptions: If extreme and/or dangerous/harmful behavior is being exhibited towards you or by you I have a responsibility to report such behavior to the proper authorities.
Payment for Services: Payment for service is due on the day of your scheduled session. Payment may be paid by invoice, cash, check or credit card. A receipt will be given if requested. Refunds are not issued for services once completed, and all deposits are non-refundable. In the case of a “no-show” you will be charged 50% of your full session cost, no exceptions.
By signing the intake form, you agree that your physical, mental, and spiritual wellness are your full responsibility, and what informed choices you make for your physical, mental and spiritual wellness, are personal, private, and made with careful consideration. You also agree that for in-person sessions that you have NOT been medically ill or exposed to anyone that has been ill or has had a virus, Covid 19, or illness symptoms in the last 7 days. This includes fever, cough, vomiting, shortness of breath etc. You also agree to fully release and hold harmless Stacie Tatera-Milwaukee Medium for any illnesses post session.
By signing the intake form you also agree that except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Stacie Tatera-Milwaukee Medium from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).
I also understand that the services I receive are not a substitute for professional, financial, legal, medical or psychiatric help, and that Stacie Tatera-Milwaukee Medium is not responsible for the interpretation of any services received. Recording of sessions is not allowed, but you are welcome to take notes. All cell phones must be silenced or turned off during any session, no exceptions.