Talk w/ Alison

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Name

First Name

Last Name

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Email

example@example.com

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Appointment* This field is required.Don't See a Time? Send a Request to Contact@MrsAlisonCunningham.com

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Select session.Please select one.

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Disclaimer* This field is required.LIABILITY RELEASE AC Creative does not provide clinical counseling or psychotherapy. AC Creative does not constitute as legal or professional advice, and neither is it intended to be. It is to be used for educational and personal growth purposes only. The client agrees that using AC Creative services are entirely at his/her own risk. Talk w/ Alison services are provided “as is,” without warranty of any kind, either expressed or implied, including without limitation any warranty for information services, coaching, or products and services provided through or in connection with the service. This service is requested at the client’s own choice and with inherent singular responsibility. Additionally, AC Creative is not responsible for any financial loss or gain based off any business advice or consulting provided in consulting services. The client understands that consulting provided are merely suggestions and counsel, but the responsibility of idea implementation and ownership belongs entirely to the client, and the client is therefore responsible for all outcomes, positive or negative, that result from utilizing consulting services. The client understands that Talk w/ Alison is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care, or substance abuse treatment, and the client will not use it in place of any form of therapy. Additionally, Talk w/ Alison is not a substitute for a business plan, nor can the consulting services be considered as a part of your business but, rather, must be considered a third-party resource. The client recognizes that coaching requires emotional, physical, and mental efforts, exertion, and behavioral experimentation, on the client’s part, which may cause physical, psychological or emotional injury. AC Creative cannot be held responsible for actions or inactions taken by the client based upon coaching or interpretation of coaching given to the client. The client fully acknowledges and takes full responsibility for all the risks involved. The client understands that it is her/her responsibility to consult with his/her primary health care provider prior to participation and should the client choose not to consult his/her health care provider, the client accepts full responsibility waiving all rights to liability or any claims against AC Creative, any of its agents, administrators, or employees. The client attests to the fact that the client has disclosed all relevant information regarding his/her physical, emotional, or mental conditions that could cause harm to the client by participating in these programs. The client or legal representatives forever release, wavier, discharge, and covenant not to sue AC Creative for any injury, harm, or death caused by either negligence or other acts. Confidentiality: The client understands that information will be held as confidential unless the client states otherwise in writing. If the client reports child or elder abuse or neglect or threatens to harm oneself or someone else, the client understands necessary actions will be taken and my confidentiality agreement is limited in this capacity. Furthermore, if Talk w/ Alison is ordered by a court to provide information or testify, she will do so to the extent the law requires. Talk w/ Alison is a professional relationship. While it often can feel like a close personal relationship, it is not one that should extend beyond professional boundaries. The client has read and understood this form and its contents and voluntarily agrees to the terms and conditions stated above.

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How did you hear about Mrs. Alison Cunningham?Select all that apply.

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Select Session Type* This field is required.$375 (1) 90 Minutes Session $295 (4) 60 Minute Sessions Each

375

USD

295

USD

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