Informed Consent and Disclosure Agreement

I understand Holly Strong is a Licensed Spiritual Healer through the approved provider with the Federation of Spiritual Healer Licensing Board, and a SomaEnergetics™ Certified Vibrational Sound Master Teacher through the Natural Therapies Certification Board.

I understand that I am responsible for my own health, healing, and well-being. I also understand I have the ability to heal myself. I further understand working with Holly Strong is not a substitute for adequate medical care, and I intend to remain under the care of my primary health care provider.

I understand that any energy healing may cause me some minor discomfort and some adverse side effects may occur through no fault of my self or Holly Strong. I further understand these services may have no effect on me.

I further understand Holly Strong will keep all information she learns about me completely confidential unless I release her in writing or as required by law. I further understand Holly Strong will not discuss anything with me publicly unless I initiate the conversation and topics of discussion.

I understand that Holly Strong is also a Licensed Massage and Bodywork Therapist in the State of North Carolina and should I desire Massage therapy service, I will need to book a separate session for that purpose.

I understand that by signing this form, I give consent to receive a session discussed in this and all future sessions and agree that my presence at subsequent sessions shall be constructed to be validation of this written consent.
I acknowledge that I have read and understand this form. I agree to allow Holly Strong to assist me in learning to heal myself using the natural healing techniques and modalities herein listed.