Art of Mindfulness Group Registration & Consent

Practice: Wellness Counseling Inc., 755 Winslow Way E. Suite 303, Bainbridge Island, WA 98110,Phone:
(360) 207-1588. Facilitator: Heather Biermann, MA, Licensed Mental Health Counselor (LMHC),

This group combines mindfulness meditation with therapeutic art making. Sessions include seated meditation, hands-on art practice (collage, painting, and clay), journaling, group reflection, and a closing grounding exercise. In the final sessions, members create a personal artwork.

Course of treatment: 8 weekly group sessions, Thursdays at 5 pm, beginning November 5, 2026. Each session lasts 90 min. Billing: The cost is $70 per session. The full series of 8 sessions ($560) is paid in advance at registration.

Refunds: 

Cancellation and Refund Policy

Refunds are based on how far in advance you cancel before the first group session:

- 30 or more days before: 75% refund ($420)
- 14 to 29 days before: 50% refund ($280)
- 7 to 13 days before: 25% refund ($140)
- Less than 7 days before: no refund

No refunds are given after the group begins. Missed sessions are not refunded or made up, but you may attend online that week.

If Wellness Counseling Inc. cancels a session, it will be rescheduled. If the group does not run, you may choose credit toward a future group or a refund.

If your facilitator recommends you stop attending for clinical reasons, unused sessions will be credited or refunded.

]Group therapy may not be covered by insurance; Wellness Counseling Inc. can provide a receipt on request. Your rights: You may refuse treatment at any time and you may choose a practitioner and treatment approach that best suits your needs. This disclosure does not create new rights for you, and it does not change any state or federal law, regulation, or professional standard.

Complaints: Contact Arilda Surridge - Director of Wellness Counseling Inc. asurridge@wellnesscounselinginc.com 

About the group: This is a therapeutic art and mindfulness group. It is not a crisis service and is not a substitute for individual mental health treatment. No art experience is needed. Participation is voluntary, and you may stop at any time. Benefits and risks: Group therapy can build coping skills, self-awareness, and connection. Art making and meditation may bring up uncomfortable feelings or memories; you may pause or step back from any activity at any time. Group confidentiality: Members agree to keep the names, identities, artwork, and anything shared by other members private, both during and after the group. The facilitator protects your information, but cannot guarantee that every group member will keep information confidential. Limits of confidentiality: Under Washington law, the facilitator may need to share information without your consent to protect someone from harm, including suspected abuse or neglect of a child or vulnerable adult, a serious threat to your own safety or the safety of others, or when required by a court order or law. Records: Wellness Counseling Inc. keeps records of your participation and protects your health information under HIPAA and Washington's Uniform Health Care Information Act (RCW 70.02). Artwork: Your artwork belongs to you. It will not be photographed or shared without your written permission. Online sessions: If you attend online, you agree to join from a private place, to be physically located in Washington State during each session, and to have a working phone available. Online services carry some risk of technical failure or privacy breach. No group member may record any session. Emergencies: If you are in crisis between sessions, call or text 988, call 911, or go to the nearest emergency room.

Your facilitator will also sign and date this disclosure and consent, and a copy will be sent to you.