Client Consent & Disclaimer Form


   
Client Consent & Disclaimer Form

I understand that the province of Alberta issues licenses to health care professionals. This licenses authorizes them to analyze, assess, diagnose, evaluate, examine and investigate their patients to determine what’s wrong with them. This license also authorizes them to advise, caution, counsel, guide, prescribe, recommend and suggest cures, drugs, interventions, remedies and treatments to address what’s wrong with them. I also understand that if I need the services of a licensed professional Jenna Henderson will refer me to one.

I understand that Jenna Henderson is a certified Holistic Nutritionist CHN and Biofeedback Technician, this allows her to educate me on stress management, stress reduction, detoxification and food nutrition.

I understand Jenna Henderson is a CHN qualified to help me understand and make a more educated decision about my own life and health. I also understand that Biofeedback can help me reduce and manage stress to improve my quality of life.

I understand that I am responsible for my own health, healing and well being. I also understand that I will advise Jenna Henderson of anything that might help us work better together. I further understand that Jenna Henderson is not a substitute for a professional medical provider and I intend to remain under the care of a professional health care provider.

I understand that my identity and personal information I share with Jenna Henderson or if she discovers it on her own, will be held in confidence, except when released by me or required by law. I have the right to waive this confidentiality agreement at any time.

I understand that I take full responsibility for my own health and wellness.Therefore I agree to use the services of Jenna Henderson to help learn about managing/reducing stress, detoxification and food nutrition.

I understand that if I have or think I have a medical concern, condition, disease, disorder, issues or symptoms, Jenna Henderson will help me reduce any related stress and refer me to a licensed healthcare practitioner for further assistance.

I also understand If I have or think I have a psychological or emotional concern, condition, disease, disorder, issue or symptoms, Jenna Henderson will help me reduce any related stress and refer me to a licensed counsellor, psychologist or psychiatrist for further assistance.

I have read and understand this form. I agree to allow Jenna Henderson to help me learn to heal myself using the natural techniques and modalities listed above.