Confidentiality Form Statement 

At Holistic Healing and Counseling, we are committed to protecting your privacy and maintaining the confidentiality of the information you share with us. We understand that seeking healing, counseling, and emotional support requires trust, and we strive to provide a safe, respectful, and confidential environment.

All personal information, conversations, counseling sessions, records, and other information shared during services will be kept confidential and handled with care. Information will not be disclosed to individuals or organizations outside of Holistic Healing and Counseling without your written authorization, except when disclosure is required or permitted by applicable law.

There are certain circumstances in which confidentiality may be limited, including situations involving a serious and imminent risk of harm to yourself or another person, suspected abuse or neglect of a child, elder, or vulnerable individual, or when disclosure is otherwise required by law or legal process.

When appropriate and legally permitted, we will discuss any necessary disclosure with you and make every reasonable effort to protect your privacy.

By participating in services with Holistic Healing and Counseling, you acknowledge that you have been informed of our confidentiality practices and understand the circumstances under which confidentiality may be limited.

Informed Consent Statement

I understand that counseling and holistic healing services are intended to provide support, guidance, personal growth, emotional wellness, and assistance in addressing concerns that may affect my overall well-being.

I understand that participation in counseling or holistic healing services is voluntary. I have the right to ask questions about the services provided, discuss my concerns, and make informed decisions about my participation. I may choose to discontinue services at any time, subject to any applicable policies or legal requirements.

I understand that counseling and holistic approaches may involve discussing personal experiences, emotions, relationships, behaviors, and other areas of my life. While every effort will be made to provide a safe, respectful, and supportive environment, no particular outcome or result can be guaranteed.

I understand that information shared during sessions will be treated as confidential, subject to the limitations and exceptions explained in the Confidentiality Statement and applicable federal and state laws.

I understand that holistic services are not intended to replace emergency medical care, psychiatric care, or other medical treatment when such care is necessary. I agree to communicate relevant concerns and seek appropriate medical or emergency assistance when needed.

I have had the opportunity to ask questions regarding the services offered and understand the nature, purpose, and limitations of the services. By signing below, I voluntarily consent to receive counseling and/or holistic healing services from Holistic Healing and Counseling.

PRODUCT DISCLAIMER:

This product is not intended to diagnose, treat, cure, or prevent any disease. This tea is not a substitute for prescription medications, medical treatment, or professional medical advice. Do not stop, reduce, or change any prescribed medication based on the use of this product. Consult your physician or other qualified healthcare professional before using this product, particularly if you are taking medication, have a medical condition, are pregnant or nursing, or are considering any changes to your medication or treatment plan.