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Energy Modulation & Compassionate Cancellation

EMC2 Healing

INFORMED CONSENT

1. MODALITY – After acquiring permission to connect, the certified Nelson Code practitioner will cancel out frequencies (trapped energetic distortions) by using a magnet on her own body, as a proctor/surrogate for the human or animal client.

After 5-20 energetic distortions have been released, a defragmentation will be run, and a number of “Days to Process” will be calculated.

 

2. SERVICE LIMITATIONS – No Practitioner representing Emotional Modulation & Compassionate Cancellation Healing (known as EMC2H hereafter) is a licensed therapist or medical doctor.

EMC2H Practitioners do not give medical, psychological advice, or provide treatment. EMC2H Practitioners do not treat or cure diseases.

 

3. SEEKING MEDICAL CARE – Clients will be advised to seek the services of medical or mental health professionals, as necessary. Examples include symptoms recognized by the common laymen (signs of heart attack, stroke, anxiety attack, etc.)

 

4. FOLLOW PROFESSIONAL ADVICE – EMC2H Practitioners are here to add opportunities of healing and balance to the body. Clients must continue to follow the advice of their licensed medical/mental health professional.

EMC2 Practitioners will not contradict any medical professional and will not be held liable if the client does not abide by their medical/mental health professional’s advice.

 

5. PRIVACY/CONFIDENTIALITY – Personal information recorded by EMC2H Practitioners include: First name, Last initial / Age / Overall Comfort Level / Issues to Explore/ Released energetic distortions / Days to process. The collected information will be recorded on an EMC2 Healing Session report and emailed to the client.

All session notes and other information will be kept private and confidential, in a locked drawer, password protected on the computer and not shared with anyone. All information discussed (history, trauma, family situation, work, etc.) is deemed “PRIVATE/CONFIDENTIAL.”

 

6. PRIVACY LIMITATIONS – Personal information collected by EMC2H Practitioners is NOT protected by “Legal Privilege.” This means that in the event, a practitioner may be required to violate a client’s privacy whether

consent has been given or not. Such events include civil/criminal investigation, court orders, and other requests from authorized jurisdictions including local, state, and the federal government.

The Practitioner may also be REQUIRED to NOT inform the client of said privacy violation.

 

7. PERSONAL RESPONSIBILITY AND RISK – Clients must agree to take responsibility for their own health and well-being. Clients assume all risks associated with conventional as well as alternative healing. Clients may

experience negative emotions/reactions that will pass (echoes). Medical devices like hearing aids and pacemakers are contraindicated and will be referred back to your medical/mental health professional for approval.

 

8. LIABILITY WAIVER – Clients waive any right to hold EMC2H, and all its Practitioners liable for any perceived harm that may result from energy healing services.

 

9. INDEMNITY – Clients agree to indemnify (defend) EMC2H Practitioners if the client causes harm to themselves and/or others.

 

10. A $50.00 additional fee applies for travel 10 miles outside of zip code 77084.

How did you hear about EMC2 Healing?

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release EMC2 Healing, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

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Schedule your service

Initial consult session plus 2 addt'l sessions of the Emotion Code, Body Code, & Belief Code combo

Book the date and time that works best for you

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Read and sign the
Informed Consent form

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