Disclaimer and Consent Statement

A few things I’d like you to know…

Clinical EFT is not counselling or psychological therapy, and I am not a licensed health care professional I do not diagnose or treat any medical or mental health conditions. If I am not qualified to help you with an issue you bring up, I may recommend you seek alternate treatment.

TALKING – Clinical EFT is not talk therapy. Although there will be some talking and I will ask you questions, my focus is to get you tapping so you can achieve your goal! For this reason, I may interrupt you. It’s not personal and it’s no meant to be rude – I want to use our time together to your best benefit and tapping will accomplish that faster than talking.

PRIVACY – Our sessions are confidential. I will take notes as we work together, but the information is stored safely and will not be disclosed.

If you have any concerns, please let me know. However, if there is immediate danger to yourself or someone else, I may have to share the information as appropriate. If this should occur, I will tell you.

If there is something you don’t want to talk about out loud, there are techniques we can use to maintain confidentiality. Please let me know if you are uncomfortable at any point.

FEES – Fees are based on the package you agree on, and an invoice will be issued prior to commencement. Payment needs to be made 24 hours in advance of your first session, or as agreed upon in regular instalments. NO REFUNDS will be issued for missed sessions.

CANCELLEATION POLICY – Missed sessions will incur a charge unless at least 24 hours’ notice is provided or in case of an emergency. Contact may be made by one of the following means:

EMAIL: RochelleSchulzEFT@gmail.com MOBILE: 1.250-300.8625 (BC, Canada - Pacific Time Zone)

SESSION – Unless we meet in person, we will be meeting on an online video conferencing app. I’ll send you an invitation with a link. When it’s time for our session just click on the link and meet me in our “room”. I also ask you for a backup number so that we can continue the phone should we encounter technical difficulties.

Please ensure you have privacy and will not be interrupted during your session. Also, I recommend that you have water available to stay hydrated (EFT works better this way!) and take care of other body issues like hunger or bathroom breaks before we start so that your body isn’t distracted.

WHAT TO EXPECT – Our first session will consist of an introduction to EFT (if required) in addition to tapping. I will also teach you how to tap on your own because EFT is most effective when you’re using it regularly. Tap on easier issues on your own, and you can save the tougher, more complex issue for your sessions with me! You will be tapping on yourself, unless our session is in person, and you are unable to do so on your own. I will demonstrate and guide you through our session together.

I am "Trauma Informed" trained and my job is to keep you safe; this means we will probably not jump directly to the big traumas or childhood problems right away.

A round of EFT generally consists of tapping on the side of the hand, followed by tapping on a series of points on your head and upper torso while talking about specific events and emotions. While some issue may be resolve in just a few sessions, it may take four or more to address complex issues propped up by various other factors (i.e. limiting core beliefs from childhood).

I, Rochelle Schulz, make the following disclosures:

I am an Accredited Certified EFT Practitioner with EFT International with additional "Trauma Informed" training.

EMOTIONAL FREEDOM TECHNIQUES (EFT)

The techniques I will be using and teaching you are based on the premise that by promoting balance and flow in the body’s electromagnetic and subtle energies, health and wellbeing are enhanced. The techniques may involve the use of certain postures or movements of stimulating by tapping specified areas of the skin on the face, upper body and hands. This helps to move, balance, enhance, and restore the body’s energies.

EFT is a brief intervention combining elements of the memory of past events or the anticipation of future events, identifying associated emotions, and somatic stimulation. It is often referred to as ‘tapping’ as it uses a two-finger tapping process with a cognitive acceptance statement.

EFT has been researched in more than 20 countries, by more than 60 investigators, whose results have been published in more than 100 different journal articles. These clinical trials have shown that EFT is able to rapidly reduce the emotional impact of memories and incidents that trigger emotional distress.

I do not diagnose or treat medical or mental health disorders, nor am I trained or licensed to do so. EFT attempts to optimize the body’s overall health and vitality, but it is not to be used instead of appropriate care from a licensed professional. In addition, the fact that EFT does not diagnose or treat illness, another difference between my services and typical visits to a medical doctor is that effective energy work requires your active involvement between sessions.

Any testimonials, examples, stories or information provided to you do not constitute a warranty, guarantee or prediction regarding the outcome of your use of EFT or any energy technique for any particular issue or purpose. The testimonials are given verbatim except for correction of grammar or typing errors or shortened where parts of the testimonial were considered irrelevant to the practice. People agreeing to the use of their testimonial have not received any material compensation.

CONFIDENTIALITY

Except for special situations described in the numbered list that follows, you have the absolute right to the confidentiality. I cannot and will not tell anyone else what you have told me, or even that you are working with me without your prior written permission. I may under certain circumstances legally speak to another health-care provider or a member of your family about you without your prior consent, but I will not do so unless the situation is an emergency. I will always act to protect your privacy to the best of my ability. You may direct me to share information with whomever you choose, and you can change your mind and rescind that permission at any time. I will endeavor to protect your information, but please note that if you elect to communicate with me by email, at some point in our work together, please be aware that email is not completely confidential. All emails are retained in the logs of your or my Internet service provider. Although under normal circumstances no one looks at these logs, they are, in theory, available to be read by the system administrators of the Internet service provider. As part of your treatment record, I will keep any email I receive from you, and any responses that I send to you.

FOLLOWNG ARE SEVEN EXCEPTIONS TO YOUR RIGHT TO CONFIDENTIALITY

1. There are some situations in which I am legally obligated to act to protect others from harm, even if I have to reveal some information about a client’s treatment. For example, if I believe that a child, an elderly person, or a disabled person being abused, I must file a report with the appropriate state or local agency.

2. If I believe that a client is threatening serious bodily harm to another, I am required to take protective actions.

3. If I believe that you are in imminent danger of harming yourself, I may legally break confidentiality and contact the police, a local crisis team, or a family member or other intimates.

4. If you tell me of the behavior of another named health or mental health care provider that suggests this person has either 1. engaged in sexual contact with a patient, including yourself, or 2. is impaired from practice in some manner due to cognitive, emotional, behavioral, or health problems, then the law requires me to report this to the relevant association. I would inform you before taking this step. If you are my client and are also a health-care provider, however, your confidentiality remains protected under that law from this kind of reporting.

5. In certain legal proceedings, particularly those involving child custody or those in which your emotional condition or treatment is an important issue, a judge may order my testimony. Confidentiality is not protected when a judge makes such an order or in certain legal situation in which such confidentialities may be an issue.

6. If I am asked to provide services to your spouse, partner, or another member of your family, we will in advance establish the limits of confidentiality. It generally confines a practitioner’s effectiveness when required to keep secrets, so my policy in most circumstances is that what you say and what we do can be shared with other family members I am working with. If this is what we establish, do not tell me anything you wish kept secret from other intimates who are receiving sessions from me. If confidential information is a concern, it may be better for each family member to work with a different practitioner.

7. I may occasionally find it helpful to consult other professionals about a client. During a consultation, I make every effort to avoid revealing the identity of the client. The consultant is also bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Although this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, please discuss with me any questions or concerns you may have. I will be happy to explore these issues with you, but formal legal advice may be needed from an attorney because the laws governing confidentiality can be quite complex.

By continuing, you agree to fully release, indemnify, and hold harmless, Rochelle Schulz, her heirs, personal representatives, consultants, employees and assigns from any claim or liability whatsoever and for any damage or injury, personal, financial, emotional psychological or otherwise, which you may incur arising at any time out of or in relation to your session(s). lf any court of law rules that any part of the Disclaimer is invalid, the Disclaimer stands as if those parts were struck out. By continuing to work with Rochelle Schulz, you agree to all the above. By completing the below, you acknowledge you are in full control of your intellectual abilities.

GOVERNING LAW The Parties hereby agree that:

a) All aspects of the relationship between the client and Rochelle Schulz, and

b) The resolution of any and all disputes arising from or in connection with that relationship, including any disputes arising under or in connection with this Agreement,

shall be governed by and construed in accordance with the laws of the province of British Columbia (other than conflict of laws rules) and the laws of Canada applicable therein.

EXCLUSIVE JURISDICTION

The Parties hereby acknowledge that the session(s) received by the client from Rochelle Schulz will be provided in / from the province of British Columbia and that the Courts of British Columbia shall have exclusive jurisdiction to hear any complaint, demand, claim, proceeding or cause of action, whatsoever arising from or in connection with the session(s), or from any other aspect of the relationship between the client and Rochelle Schulz.

MINORS

If you are under eighteen years of age, please be aware that the law may provide your parents or legal guardians the right to examine my records of our work together. It is my policy to request a written agreement from parents to waive their right to access your records. If they agree, I will provide them only with general information about our work together unless I feel there is a high risk that you will seriously harm yourself or someone else. In this case, I will notify them of my concern. Before giving them any information, I will discuss the matter with you.

*Clients 18 yrs and under must have their parent/guardian name typed in addition to theirs, granting permission in the space provided.

Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless (Name of Practitioner) from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).