CLIENT INFORMED CONSENT FOR ENLIGHTEN OC

Thank you for booking a session with Ari Karampour

Please review and submit this consent form prior to your session.

Your session will combine and integrate energy and healing modalities, eastern medicine, sound resonance therapy, past life regression and belief coaching to facilitate clearing energy blocks, physical and emotional pain, inner child trauma and negative beliefs.

It is important to note that your session will vary each time, depending on what needs to be healed on any given day or at any given moment. Therefore, no two sessions will be alike.

My goal is your whole wellness - Mind, Body, and Spirit - and to help you live the life you came here to live; free of limitations.

Please note: these sessions are not designed, nor does it make any claims to be a substitute for, traditional psychotherapy or medical treatment. Those with a history of mental illness should seek treatment from a licensed mental health professional.

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Ari Karampour
Enlighten, Orange County
Email *
Full Name *
I understand that Ari Karampour is not a medical doctor or licensed mental health professional and acknowledge that I am not seeking these services *
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I understand that Ari Karampour is not able to prescribe any medication *
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I understand that any information given to me by Ari Karampour is to the best of her knowledge and that she will not be held responsible nor liable for such information at any time in any Court of Law
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I understand that any advice given to me by Ari Karampour is based on her beliefs and that at no time will I be asked to adhere to these beliefs
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I understand that during sessions instruments such as sound bowls, singing bowls, tuning forks will be used to achieve vibrational resonance and that I should let Ari know if I am not comfortable with any of these instruments *
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I understand that my information is private and confidential and will not be shared with anyone and that the content of this consent in and of itself is confidential and will be stored securely and confidentially
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I understand that Ari Karampour, although not a medical doctor, is committed to the same oath of confidentiality
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I understand that this consent form will apply for the entire course of my sessions with Ari Karampour and should this consent change at any time, that I will be provided the new consent form
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I understand that insurance is not accepted and that payment for each session is due immediately after the session
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I understand that in-person sessions will entail light touch to my head, ears, throat, shoulders, arms, feet and upper back and that I will let Ari Karampour know if I am not comfortable with light touch in any of these areas *
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I understand that Ari posts to social media and may use me as a case study to help others. I also understand that Ari will not provide any information that may in any way reveal my identity in these videos. *
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I understand that Ari Karampour is not an employee of MDitate or Dr. Adam Rotunda  *
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