Blossom
Anne (Annie) Jamrose
Liability Waiver release &
Informed consent to treat for personal energy healing session

Subtle energy modalities such as energy healing are recognized under NCAM, the American National Center for Complementary and Alternative Medicine. Complimentary and Alternative Medicine recognize that treatment modalities must align with the complex interconnections between the physical, emotional and spiritual bodies. Ancient Eastern disciplines such as Chinese medicine, Qi gong, acupuncture, and yoga work with subtle energy systems, within and around the physical body and act as a conduit system through which our spirit connects our physical body to the earth.
Creating harmonious energy fields provide an alignment, personal empowerment, and renewed/increased energy or life force.  In energetic integrity we are able to create and manifest what we desire in our lives. When our physical, emotional, or spiritual body are out of alignment due to emotional trauma, physical injury, unresolved memories, environmental or food toxins, addictions, poor relationships, or living ungrounded, we lack the necessary vitality for life and can become physically ill, depressed, stuck, and have difficulty creating a holistic harmonious life.
Both conscious and unconscious thoughts, fears, personal history, grievances, intentions and belief systems as well as family, friends and society belief structure and systems become imprinted into our subtle energy systems as well as physical body. This impacts how one feels and expresses oneself in the world. During personal sessions Life Force Energy is presented to the client and applied to heal the subtle energy systems in support of healing the body and spirit.
Personal sessions provide various sensations during and after a session depending upon the topic or issue covered. Clients may sometimes experience an increased flow of energy throughout their body and personal space creating an increased sense of well-being. As well, energy work may bring about the release of old emotions such as grief, sadness or anger as part of the healing process and may also bring forward outdated energetic patterns, including but not limited to, relationships with work, friends and family members. Clearing such imbalances in your subtle body may be reflected in your relationships with others and the world. Clients often find it appropriate to relax right after a session and allow the integration of the energy work to continue. Drinking water and relaxing allows the body to eradicate old toxins and energy and provide the body to integrate the energetic alterations.
If you experience any discomfort that you believe is a result of any aspect of the healing, please communicate this experience to me. Energy medicine as a holistic health practice is a personal choice in self-discovery and personal transformation and evolution.

Anne Jamrose - Blossom Energy Body Work Consent Form

Energy Healing Modalities Informed Consent to treat
I hereby request and consent to the performance of energy healing modalities and treatmentsonmyself, or the patient named below, for I am legally responsible.
I understand that methods of treatment may include, but are not limited to: energy balancing and harmonization, Reiki, chakra harmonization, energy healing, meditations, and counseling. I will immediately notify my energy practitioner listed above of any anticipated or unpleasant effects associated with any of the energy modalities applied.
I have been informed that energy medicine is a generally safe method of treatment, but that shifts in energy occur and may create some physical, emotional, or spiritual side effects which may include physical tingling, feeling lighter energetically, mild fatigue, nausea, muscle soreness, headache, thirst, changes in relationships, shifts in perception, etc. I do not expect the energy practitioner to be able to anticipate and explain all possible risks and complications of energy treatment, and I wish to rely on the energy practitioner to exercise judgement during the course of treatment which the energy practitioner exercises a best and highest interest for healing, based upon the facts then known and for my best interest and highest good. I understand that results are not guaranteed.
I understand that all clinical information and records of energy healing treatments etc, will be kept confidential and will not be released without my written consent.
By voluntarily signing below, I show that I have read, or have read to me, the above consent to treatment, have been told about the risks and benefits of energy medicine and intuitive energy healing and other energy modalities, and have had an opportunity to ask questions. I intend this consent from to cover the entire course of my energy treatments for my present condition and for any future condition(s) for which I seek any energy healing modalities.

 

 

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