Sangoma Holistic Health Center

Client Confidentiality and Privacy Notice

 

At Sangoma Holistic Health Center, your privacy and confidentiality are of utmost importance to us. We recognize and respect the sensitive nature of the information shared during our sessions. As such, we have implemented strict policies and procedures to ensure the protection of your personal information.

 

Confidentiality:

 

1. Client Profile Records: Your client profile records are strictly confidential. You have the right to access and review these records upon written request. To facilitate this process, please email your request to MaelitaSimmons@sangomahhc.com or contact us at (623) 888-4407 for further assistance.

 

2. Exceptions to Confidentiality: While we uphold your right to privacy, there are certain circumstances where confidentiality may be limited. These exceptions include:

 

   a. Written Consent: You may authorize the release of your information to other healthcare practitioners or individuals by providing written instructions.

 

   b. Legal Obligations: If we receive a subpoena or any other legal obligation that requires the disclosure of your information, we may be compelled to comply. This includes situations where there is clear and imminent danger to yourself or another person.

 

   c. Record Storage and Retention: Your confidential client profile is securely stored for a period of five years after the termination of services. Upon expiration of this timeframe, all information will be appropriately and securely destroyed.

 

   d. Legal Requirements: Please note that your confidentiality remains subject to the usual exclusions dictated by state and federal laws and regulations.

 

By acknowledging this notice, you confirm that you have read and understood our privacy policies and the exceptions to confidentiality as outlined above. You further acknowledge that the experiences shared during our sessions are confidential but may be subject to the usual exceptions governed by the laws of the State of Arizona and other federal laws and regulations.

 

Your trust is paramount to us, and we are committed to maintaining the highest standards of client confidentiality and privacy.

Maelita Simmons, with extensive experience in the healthcare field and a background in chemically made medicines, transitioned to natural-based medicines in 2017 due to personal health issues. With a diverse skillset including energy work, meditation practice/teaching, womb care, doula services, holistic health coaching, reflexology, Nutrient Certification, and ongoing studies to become a certified yoga instructor, Maelita offers a comprehensive approach to wellness. For additional information regarding certifications and testimonials, please click here.

 

I acknowledge that Maelita Simmons is not a licensed physician or coach, as her current scope of care is unregulated. Consequently, her services are not licensed by the state of Arizona. It is my responsibility to maintain a separate relationship with a medical doctor, mental health professional, or any other essential specialized health professional, if desired. I also understand that Maelita Simmons is not trained to diagnose illnesses, provide recommendations involving pharmaceutical drugs or surgery, or handle medical emergencies. Furthermore, I understand that the statements and services offered by Maelita Simmons have not been evaluated by the US Food and Drug Administration.

 

By signing this agreement, I hereby release, waive, acquit, and forever discharge The Womb Sauna and Maelita Simmons, including their agents, successors, assigns, personal representatives, executors, heirs, and employees, from any claim, suit, action, demand, or right to compensation for damages that I may claim to have or that may arise due to acts or omissions by myself or by Maelita Simmons, including recommendations provided or resulting from any booked sessions. I further declare and represent that no promise, inducement, or agreement not expressed in this agreement has been made to me to sign this agreement. This agreement shall bind my heirs, executors, personal representatives, successors, assigns, and agents.

 

Except in cases of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless The Womb Sauna and Maelita Simmons from any claims or liability of any kind or nature arising out of, or in connection with, my session(s).

Please carefully review and sign the following information. If you have a specific medical condition or experience specific symptoms, reiki/bodywork may not be suitable for you. In such cases, a referral from your primary care provider may be required prior to receiving our services. 

 

I understand that the reiki/bodywork, holistic coaching, reflexology, foot detoxing, meditation, and yoga exercises provided are intended for energy/womb healing, lifestyle changes/cleansing, and body movement. If I experience any pain or discomfort during the session, I will promptly inform the practitioner so that adjustments can be made to ensure my comfort. 

 

I further understand that energy/bodywork, holistic coaching, foot detoxing, meditation, and yoga exercises should not be considered a substitute for medical examination, diagnosis, or treatment. If I have any mental or physical ailments, I acknowledge the importance of seeking assistance from a qualified medical specialist, such as a physician or chiropractor. I understand that reiki/bodywork practitioners, holistic health coaches, reflexology, meditation, and yoga teachers are not qualified to diagnose, prescribe, or treat any physical or mental illness. Therefore, I should not interpret any statements made during the session as such.

 

In order to ensure your safety, I affirm that I have disclosed all known medical conditions and answered all questions honestly. I acknowledge that reiki/bodywork, yoga, foot detoxing, reflexology, and holistic coaching should not be performed under certain medical conditions. I take responsibility for keeping the practitioner informed of any changes in my medical profile, and I understand that the practitioner cannot be held liable if I fail to provide such updates.

 

Lastly, I understand that any inappropriate or sexually suggestive remarks or advances made by me will result in the immediate termination of the session, and I will be held accountable for payment of the scheduled appointment.

To the best of my knowledge, I am in good physical condition and fully capable of participating in the courses/services/sessions provided by Sangoma Holistic Health Center. I acknowledge and understand that there are inherent risks and hazards associated with these activities, which may pose a potential threat to myself and my property. I willingly and voluntarily accept full responsibility for any risks, loss, property damage, or personal injury, including death, that may occur as a result of my participation in these courses/services/sessions.

 

By signing this agreement, I hereby release, waive, discharge, and covenant not to sue Sangoma Holistic Health Center, including their officers, servants, agents, and employees (hereinafter referred to as RELEASEES), from any and all liability, claims, demands, actions, and causes of action, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or occur upon the premises where the courses/services/sessions are being conducted.

 

I expressly intend for this release and hold harmless agreement to be binding upon my family members, spouse (if I am alive), and my heirs, assigns, and personal representative (if I am deceased). It shall be deemed as a release, waiver, discharge, and covenant not to sue the above-named RELEASEES. Furthermore, I agree that this Waiver of Liability and Hold Harmless Agreement shall be governed and construed in accordance with the laws of the State of Arizona.

 

By signing this release, I acknowledge and represent that I have read the foregoing Waiver of Liability and Hold Harmless Agreement, fully understand its contents, and voluntarily sign it as my own free act and deed. I confirm that no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made to me. I execute this release with the understanding that I am doing so for full, adequate, and complete consideration, and with the intention of being legally bound by its terms.

Womb Sauna Liability Statement:

 

In order to ensure the safety and well-being of all clients, we kindly request that you adhere to the following recommendations while using the Womb Sauna. The use of drugs, medication, or alcohol prior to or during the sauna session may result in dizziness or unconsciousness. If you have any doubts about your ability to use the Womb Sauna for health reasons, we strongly advise consulting with your physician. Should you experience lightheadedness, dizziness, or heat exhaustion, we recommend discontinuing the sauna session immediately.

 

To maintain a safe experience, we recommend limiting Womb Sauna sessions to a maximum of 60 minutes. It is important to hydrate adequately by drinking plenty of water before and after each sauna session. We also advise refraining from eating at least one to two hours before using the sauna to prevent any discomfort. If you are currently taking any medications, it is crucial to consult with your physician or pharmacist prior to using the sauna.

 

Pregnant women should consult with their physician before using the Womb Sauna, as excessive body temperatures can potentially harm the fetus during the early stages of pregnancy. Additionally, please refrain from applying any chemicals or lotions before your sauna session, as these substances can block pores, affect perspiration, and stain the wood.

 

By checking the agreement box below, you acknowledge and accept the inherent risks associated with using the Womb Sauna. You voluntarily assume any risk of injury, accident, or death that may arise from its use. Furthermore, you release the Womb Sauna, its employees, independent contractors, and representatives from any claims or liabilities for personal injury or property damage that may occur during your time in the sauna or as a result of any advice provided.

 

Please note that this liability statement and waiver apply to all Womb Sauna sessions and remain in effect unless otherwise requested by either party.

 

If you experience any adverse reactions or sustain any physical injuries during your treatment, we kindly request that you complete the Client Incident Report within 24 hours using the following link: http://bit.ly/wsclientir . Thank you for your cooperation and understanding.