I. INFORMED CONSENT AGREEMENT,
TERMS & CONDITIONS.
By booking a session with Kalisa Augustine, you agree to these terms.
Healing involves both benefits and risks. Risks include the possibility of experiencing uncomfortable levels of feelings like sadness, guilt, anxiety, anger, loneliness and helplessness. Alternative therapy, emotional healing and growth often requires recalling experiences, some of which may be unpleasant. Healing may involve making changes that can feel uncomfortable to you and those close to you. Should you notice any negative effects, please tell me immediately.
I will make every effort to remedy the situation or provide you with names of other practitioners should you prefer a referral. Working with trauma, emotional processes and energy healing have been shown to have benefits for those who undertake it. It often leads to reduction of feelings of distress, and to better relationships and resolution of specific problems. The objective is to find more peace, joy, a sense of purpose and maintain healthier relationships.
Please read the following statements carefully. If you are comfortable with and agree to all terms, please continue booking a session with Kalisa Augustine. Sessions usually occur weekly or bi-weekly, until all healing and growth goals are complete. Kalisa Augustine’s services are ongoing therapeutic processes. It is required that you understand and consent to the following terms regarding your healing sessions and experiences. I look forward to working with you.
If you have a specific request for a single one-off session -- please contact Kalisa directly to make arrangements. Thank you.
1. I agree to have a credit card saved on file to be used for regular weekly sessions and fees incurred. I understand that my card is charged on the day of my session as a convenience unless otherwise specified by the client, discussed and agreed upon by both parties. I understand Kalisa also accepts Venmo, however a credit card must be on file as a secondary payment option. If Venmo is being used, my payment must be made prior to the session, otherwise my credit card will be charged.
2. I understand that after booking my initial client intake and choosing to work with Kalisa, there is a commitment to consistent sessions, weekly or bi-weekly until all issues are resolved. Commitment and devotion is required in order to work with Kalisa Augustine. I understand that my participation and commitment is a necessary component of my personal growth. I understand that healing can take years and will discuss a treatment plan to discontinue therapy when the time arrives. Arrangements can be made to accomodate for public holidays; emergencies etc.
3. I understand that somatic, neurophysiological, trauma, and energy healing processes may affect my physical, emotional, mental and spiritual states of being while I integrate the benefits of my healing work. I understand that integration may feel intense, uncomfortable or foreign at times. I understand this and am willing to show up for myself, anyways.
4. I understand the possible temporary side affects from my treatment could manifest as: fatigue, sense of loss, exhaustion, minor pain, physical detox, emotional detox, brain fog, anguish, revelation, increased sensory intelligence, heightened sensitivity, and potentially a desire to change my life externally.
5. I understand that a minimum of 48 hours is required for the brain to reach a state of coherence after trauma focused healing, energy therapy, emotional processing or expansion sessions with Kalisa.
6. I understand that the effects of healing treatments with Kalisa Augustine vary from person to person depending on individualistic client conditions.
7. I understand no guarantee can be made concerning the results of the treatment.
8. I understand that working with Kalisa Augustine is not a replacement for standard medical treatment.
9. Should any medical or psychiatric emergencies arise, I assume full responsibility to consult with the appropriate physicians. I understand that Kalisa Augustine is not a medical doctor.
10. I am aware that treatment may include but is not limited to brainspotting, counsel, coaching, crystal bed therapy, parts therapy, mentorship, vibrational medicine, energy healing, spiritual teaching on consciousness expansion.
11. I understand that the efficacy of the work is supported by commitment and appointments are scheduled weekly until I have accomplished the majority of my goals and other arrangements are made. I understand that committed participation is required to support the integrity of my growth. If I want to have a single session to try it out, that's cool. After my first session I plan to communicate with Kalisa or her office about my growth goals and committed plan.
12. I understand that Kalisa is an awesome badass forever.
CONFIDENTIALITY:
As part of the counseling process, I am bound by moral accountability to keep confidential the information shared during the sessions and will not release any information without your written permission. There are important exceptions to the confidentiality of the counseling relationship.
I may reveal certain information under the following circumstances:
a) Disclosure of serious intent to do harm to self or others.
b) Disclosure of child abuse or my suspicion of child abuse, elder abuse, or dependent adult abuse.
CANCELLATIONS AND MISSED APPOINTMENTS:
Cancellation of appointments must be made at least 24 hours in advance. A credit card number will be taken at the onset of your appointment. Late cancellations will be charged at the regular hourly fee to your credit card.
PAYMENT:
Payment is expected at each session unless other arrangements have been made in advance. You are responsible for payment for all services rendered either by debit card, credit card, or Venmo. You agree to have a credit card on file to book your appointment or to make arrangements for an alternative form of payment with Kalisa Augustine.
TELEPHONE, TEXT AND EMAIL POLICY:
Generally, I ask that clients reserve discussing problems that arise between sessions for the next scheduled appointment time. We encourage you to use resources you have and to reach out to your support system. Unless there is an emergency, our schedules do not permit us to talk on the phone, respond to lengthy texts or answer lengthy emails in between sessions. If you feel the need to text or email information beyond the routine scheduling of appointments, or corresponding follow ups, we will wait to discuss the content in our next scheduled session. If telephone calls are necessary for a client emergency, please schedule a time for a telephone consultation, which will be charged at our regular rates (In 15-minute segments). Please do not text anything other than appointment times as confidentiality is not secure with texting.
I hereby request and consent for Kalisa Augustine to perform treatment according to professional standards as outlined on the website www.kalisaaugustine.com and as stated in this agreement.