*A staff member will contact you following your booking to confirm your appointment. **Your appointment may be scheduled up to 10 business days after receipt of payment.***Occasionally, it is necessary to reschedule appointments due to last-minute changes in Kim’s calendar. We apologise, in advance, for any inconvenience that may be caused.

• Sessions are conducted by telephone, Skype, Zoom, or Psychology Today therapy room.
• All fees for are non-refundable and subject to GST.
• Agreement: In consideration of the purchase of an appointment it is your intent to agree to and comply with the terms below.
• Instructions and time choices will be emailed within 10 business days after receipt of your payment.
• Kim does not work on weekends or holidays **Emergencies are the exception**
• Kim is limited in the number of appointments she is able to fill. Please note that completion of this form will not guarantee an appointment. Each case will be reviewed by Kim prior to confirmation.

During the time that Kim is doing the work, you will be asked to lie in a comfortable position.

Please check (V) any of the following conditions below that currently affect you or that you have experienced in the last 5 years.

*If you have been diagnosed with a chronic disease such as heart disease, cancer, or diabetes please be under the care of a physician. 

Acknowledgment and Consent

I affirm that the information provided is accurate and true to the best of my knowledge. I understand and agree that the services, techniques, recommendations, or suggestions provided by Kim M. U-Ming are not intended to replace the examination, advice, diagnosis, or treatment by a licensed medical professional or healthcare provider. I acknowledge that decisions regarding my health and well-being remain solely my responsibility, and I agree to promptly notify my healthcare provider of any physical, mental, or emotional changes that may arise.

I fully understand and agree that Kim M. U-Ming is not a medical doctor, licensed physician, or any other type of medical practitioner. She has not represented herself as possessing medical training, expertise, or licensure, and she does not diagnose medical conditions, prescribe medications, manipulate bones, or provide any treatment for injuries, ailments, or diseases. I accept that any information or suggestions provided are not a substitute for professional medical advice and are entirely voluntary.

I affirm that I have not been pressured, coerced, or unduly influenced by Kim M. U-Ming to participate in any service or to use any product, technique, or substance. I understand that any unconventional or alternative methods used are undertaken with my full knowledge and informed consent. I voluntarily assume all risks associated with these services and freely choose to proceed.

Release of Liability

I, the undersigned, on behalf of myself, my heirs, successors, executors, administrators, and assigns, hereby release, indemnify, and hold harmless Kim M. U-Ming, her associates, and their respective heirs, successors, executors, administrators, and assigns from any and all claims, actions, demands, or liabilities arising out of or in connection with any services provided. This includes, but is not limited to, claims for injury, damage, or loss to person or property, whether foreseen or unforeseen, resulting from participation in any service or session.

I expressly acknowledge and agree that any engagement with Kim M. U-Ming is provided on the understanding that the outcome is not guaranteed. I accept full responsibility for any decisions or actions I take based on the services or information provided.

Cancellation and Rescheduling Policy

I understand and accept that any appointment that is cancelled, missed, or for which I arrive more than 15 minutes late will result in the session being forfeited and the fee being non-refundable. I also understand that any rescheduling must be requested and confirmed at least 48 hours prior to the originally scheduled session time.