Disclosure and Consent for Online Inner Healing Session(s)
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Alice Arlene Ltd. Co.

Theoretical Orientation and Integrative/Systems:

Intervention is based on the belief that problems and solutions exist within an individual or relational “system” for some logical function, rather than in individual “pathology” and that the mind and body are inextricably interdependent. Interventions are based on belief that the subconscious catalogues the individual’s life experience and that previous trauma tends to cause current symptoms. Mind/body interventions are employed to clear previous trauma, thus relieving the current symptom.

Statement of Confidentiality

The Client-Practitioner relationship offers confidentiality in so far as allowed by state law. Under certain conditions, the right to confidentiality is necessarily violated. Those conditions include the potential for suicide or homicide on the part of the client. Likewise, when there is reason to suspect that physical or sexual abuse has occurred to a child, the practitioner is required by law to report the situation to the Department of Human Services Child Protective Services division. I may also seek counsel from mentors and spiritual leaders as needed for my growth, discernment, and covering.

Confirmation of Appointments

Clients will be emailed to schedule and confirm appointments. Confirmation of appointments must be received the evening before your appointment or your appointment will be cancelled. Appointments may be rescheduled within 24 hours of your scheduled time. No shows will forfeit all monies paid.

Consent and Disclosure

I have read the preceding information and understand my rights as a client. I do hereby accept full responsibility for any and all actions taken by myself and/or my child concerning any assignments, mind/body work or prayer work with Alice Briggs. I understand that I am not receiving medical diagnosis, medical treatment or prescriptions, but mind/body interventions and suggestions. I understand that Alice Briggs is not a licensed therapist or counselor but a Splankna practitioner who is also trained in SOZO, Restoring the Foundations, and NAET. I understand that although Alice Briggs is a licensed Occupational Therapist, all Splankna work is not related to, or under the auspices of that knowledge, degree, or license, but is a wholly separate training and method of work. Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Alice Briggs and Alice Arlene, Ltd. Co. from and against any and all claims or liability whatsoever kind or nature arising out of or in connection with my session(s).

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