Informed Consent & Liability Waiver

From the Therapy Practice of Amber St. Germain

Please review the following:

1. I agree to hold harmless Amber St. Germain and will not pursue legal action of any kind against her for any reason. 

2. I will agree to mediation and to cover the cost of mediation if needed, provided both parties agree to mediation for any disagreements or conflicts between the individual parties that cannot be resolved in therapy.  

3. I acknowledge that Amber St. Germain is not licensed in any state and is practicing as a coach and healer with a Clinical Psychology Marriage and Family Therapy Degree, focusing on Somatic Therapy or Body-Based Therapy so that she is not limited to only working with clients in any one state in which she is licensed.

4. If I have booked an in-person session, due to the somatic nature of the work, clothes-on, non-sexual touch, and bodywork may be an option during the therapeutic journey. If so, touch will be discussed ahead of time and will always be consensual.

5. I agree to take responsibility for my own health and well-being, including my mental health. I understand that ultimately, I am responsible for my own happiness and therapeutic results.

I agree that by typing my full name below, I consent to all terms in this Agreement.  

Powered by