I understand that energy healing, including The Body Code and The Emotion Code are energy healing modalities that may be used as part of a session with Kelsey Hentzen, Emotion Code Practitioner. These methods seek to identify and eliminate underlying imbalances by releasing energetic imbalances such as limiting beliefs and trapped emotional energy. These methods of energy healing promote harmony and balance within, relieving stress and supporting the body, mind, and spirit in their natural healing processes. 

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I understand that releasing trapped emotions, or the correction of any other energetic imbalance using these methods as practiced in, is not a substitute for medical or psychological care. This information is not intended as medical advice and should not be used for medical diagnosis or treatment. Information received is not intended to create any physician-patient relationship, nor should it be considered a replacement for consultation with a healthcare provider, nor is it meant to replace any medical treatments as ordered by any physicians nor any other medical care you have been advised to seek by them. I further understand that these methods are not a replacement for any professional psycho-therapeutic or counseling sessions in the treatment of any mental health issues or disorders.

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I understand that if I have health or well-being concerns, I am recommended to seek advice from an appropriate medical practitioner before making any decisions about my health, and that this information is offered as a service and is not meant to replace any medical treatment.

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I understand that these sessions are confidential, and that any personal information would be used anonymously for training or promotional purposes only, subject to any exceptions governed by laws of the State of residence of my practitioner listed below, or of Federal laws and regulations, and that identifying personal information such as my last name and city will be deleted to maintain my privacy, unless required by law. 

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If any term of this Agreement is to any extent invalid, illegal, or incapable of being enforced, such term shall be excluded to the extent of such invalidity, illegality, or unenforceability; all other terms in this agreement shall remain in full force and effect.

I understand that by signing this form, I fully consent to participating in the energy healing work in the scheduled session including group energy healing session(s) as part of my full participation.