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General Intake Form

General Intake Form

Informed Consent and Liability Release 

Intuitive or Mind Body Healing fits into the category of a faith based modality. It is educational guidance that intends to provide support for life improvement and vitality with the blessings provided by "the divine". Mind Body or Intuitive Healing is not a replacement for conventional medical treatment, but may be used as a support with your medical team. The processes of Mind Body Healing is not specific to any age, sex, race, color or creed or religion.

1. I understand the above statement in regards to services offered and give permission for Julie Stone to provide wellness education and guidance in private or group sessions. I understand that it is my choice to follow any recommendations provided, and I can stop the services or sessions at any time.

 2.  I declare and understand that I am capable of making decisions for myself, I am in charge and responsible for my mental, emotion and spiritual well-being and I know my body and situation better than anyone else. I have or will disclose any information (health or otherwise) that may contradict or alter the effectiveness of services offered.

3. I acknowledge that the Julie Stone is not a counselor, psychologist, psychiatrist or physician of any kind. I understand that Julie Stone is not licensed to diagnose illness, disease or any other physical or mental disorder.  I clearly understand that any type of Mind Body, Intuitive Healing or nutritional/herbal education used including but not limited to Theta Healing, Laying of Hands or Guided Meditation is not meant to diagnose, treat or be a substitute for a medical examination and or treatment. l or my representative(s) agree to full release and hold harmless , Julie Stone, from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s) or educational information.

4.  I understand that I need to visit my personal physician for any ailments that I may be experiencing, and seek approval from my doctor before starting any new regime, foods or supplements.

5.  I acknowledge that no assurance or guarantee has been provided to me as to the results of the private or sessions, education or classes or literature.

6. I understand that if at any time I feel discomfort or have a problem with the session, it is my responsibility to voice my concerns.

7.  I understand that payment is required prior to services offered:  I agree to give 24 hours­ notice for cancellation to avoid a cancellation fees. At any time during a session or class - I can request to stop the session or leave the class, and may request a refund for any unused services.

Client Background
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Locations:

Any where in the world by phone. 

Tel: 1-919-378-0900

Southern California (part-time)

Laguna Health and Wellness Center

24351 Moulton Parkway

Laguna Woods, CA 92637 USA

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DISCLAIMER: Julie Stone is not a medical doctor, psychologist or psychiatrist and does not make medical diagnoses. Julie Stone does not prescribe medications and/or medical treatments and she does not interfere with the prescribed medications and/or with medical treatments. Education and mind body sessions are not meant to replace your doctor or be a substitute for professional medical care or treatment. Julie Stone offers non-medical complementary educational services intended to support self-healing. There is no guaranteed outcome with  mind body sessions. For medical related symptoms and/or conditions, please consult a medical doctor. Julie Stone is a member of Divine Healing Private Membership Association.

No actors or scriptwriters were used to gather any client testimonials.

©2024 Julie Stone. All Rights Reserved.

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