Client Agreement & Consent 

You are entering a Professional Relationship.  All Information will be treated confidentially.

 

Your Agreements:

 

➤   I agree to allow Edsia van Wyk to share information in a straightforward manner.

 

➤   I have the right to reject any or all suggestions.  I agree to remember that I have free will to expand my Beingness or remain where I am on the path I have chosen up to the present time.

 

➤   I agree to allow each session to be a discussion about what is most important for me right now in my life even if that means that all my questions may not be answered.

 

➤    I agree to participate in this session, actively recognizing what is being said, and I agree to speak up during the session, when I do not understand, do not agree, or do not accept the guidance or when something does not resonate - so that it can be clarified, I have the right to terminate the session at any time, without monetary refund. I agree to be open to what is shared, with the understanding that I don’t need to accept it; just look at it and be open minded.

 

➤   I understand that spiritual counseling can support my personal growth, transformation and healing process, and help me connect more deeply to my own inner wisdom and spiritual guidance. I understand that spiritual counseling is not a substitute for professional medical or psychological assistance.

 

➤   I understand that a spiritual counselor is not qualified to diagnose or treat illnesses and that if I am dealing with a serious physical or mental health issue that I need to consult with a qualified health professional.

 

➤   I agree to honor these agreements for the duration of the session regardless of what may occur.

 

 

Disclosure of Information

 

     The information disclosed in this form and other forms relating to these services might be used to assess guidance steps when participating in these services. Please ensure that you answer all questions factually in order to minimize any risks.

 

All information collected in this form is treated strictly confidential and will be handled with utmost confidence.

 

      Because counseling should not be performed under certain psychiatric conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly.

 

     I agree to keep my counselor updated as to any changes in my medical profile and understand that there will be no liability on Edsia van Wyk’s part should I fail to do so.

 

 

Disclaimer

 

Edsia van Wyk nor Infinite Being Institute™️ will not accept any liability for any accidents, injuries or losses as a result of these services.

 

 

Indemnity

 

      I agree to indemnify and hold Edsia van Wyk, Infinite Being Institute™️, affiliates, suppliers and employees, harmless from any claim or demand, including reasonable attorney fees and court costs, made by any third party due to or arising out of services provided: my breach of any of the representations and warranties herein, or your violation of any rights of another.

 

 

Personal Consent

 

 

➤   I am aware that Counseling Session does not diagnose illness or disease, does not prescribe a course of treatment, and that any information communicated will not be construed as such.

 

➤   I understand that the information herein is to aid the Counselor in giving better service and is completely confidential.

 

➤   If I experience any physical or emotional pain or discomfort during any session, I will immediately inform my Counselor.

 

➤   I also understand that it is within my rights as a client to terminate the session at any point if I so choose.

 

➤    While recognizing that all due care will be taken by my practitioner and I voluntarily enter into Sessions.  I understand Counseling is a joint endeavor between the Counselor and client, and specific results are not guaranteed.

➤   I will be informed if Edsia van Wyk believes Counseling is not appropriate for my circumstances or that I should be referred elsewhere.

➤   I understand that effective Counseling involves my attending regularly scheduled Counseling appointments and talking openly with my therapist.

 

 

 I __________________________________________ have read and understand all information on this form. Anything written on this form is factual and true.

Signed: __________________________________                                  Date: ____________________________

 

 

Signed: ___________________ Date: ________________________

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