Waiver, Release, and Assumption of Risk Form
1. I am not a certified psychologist or guidance counselor.
2. I am not practicing medicine.
3. I do not diagnose illnesses.
4. I do not prescribe or adjust medication.
5. There is no guarantee of results.
This form is an important legal document. It explains the assumption of any and all risks in deciding to follow the advice or insight, or use of products from any therapist who operates as an advising consultant through Quinta Essentia. It is critical that you read and understand it completely. Accepting a session with Quinta Essentia or a representative of that business implies that you have read and agree to the Waiver Release and Assumption of Risk.
Waiver, Informed Consent, and Covenant Not to Sue
I hereby acknowledge I have volunteered to participate in a paid or unpaid session, class, workshop, service or program with a therapist through Quinta Essentia to include, but also may not be limited to, any and all services provided, such as energy healing, intuitive coaching, guidance, and group sessions. In consideration of the Quinta Essentia agreement to, assist, advise, or train me, I do here and forever release and discharge and hereby hold harmless the business and its respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in a session or purchase or any program WITHOUT LIMITATION, WHICH MAY OCCUR AS A RESULT OF following advice tendered and released or training rendered or use of facilities during a session or event.
I recognize that in no way does any member of Quinta Essentia provide legal, medical, or therapeutic advice and it is my responsibility to secure such advisement. I acknowledge and agree that I assume the risks associated with any and all activities, offerings, products, services, classes and/or programs in which I participate or purchase.
I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from any insight, guidance, product or program. I understand that results are individual and may vary.
I further acknowledge I am NOT granted permission to audio record my sessions with any therapist through Quinta Essentia. I understand that I MAY NOT share any recordings of sessions rendered, in part or in whole, privately or publicly in any form, as to do so would violate the terms of this agreement, breach trust, and break a code of privacy. Any unauthorized use, sharing, broadcast or release, personally or publicly, in any form, of a recorded session, is strictly prohibited and would be considered an illegal act and punishable by law.
I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY ACKNOWLEDGING AND AGREEING TO THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST QUINTA ESSENTIA FOR NEGLIGENCE OR THAT OF ITS EMPLOYEES, AGENTS, OR CONTRACTORS.