WIRED SHAMAN: CONSENT FORM FOR SHAMANIC HEALING SESSION

The purpose of this consent form is to explain my intent as well as what you can expect of a healing session. I’ll perform specific shamanic healing techniques with my energy field and when appropriate with my hands. These techniques may balance, clear, and charge your energy field and system, release energetic blocks that lead to disease, and enhance your body’s natural healing potential.

During your session we may discuss the major stresses in your life, belief systems, childhood, health history, habitual thoughts & patterns, and other issues that have influence on your emotional, mental, and physical well-being. Confidentiality is assured. Be aware that I may discuss, in confidence, our work with a supervisor or professional peer for the purpose of my continuing professional development and to improve my ability to serve you. At all times our healing is your responsibility. I am available to be your committed shamanic practitioner in this process. I will not and cannot advise you to discontinue any medical treatment you may be receiving. My work is intended to be in harmony with any other healing work that you undertake, including conventional Western medicine.

Please feel free to discuss our work with your doctor. I am not a physician, and therefore do not diagnose disease or prescribe drugs. I serve as a Shamanic Healing Practitioner.

It has been made clear that shamanic healing is not a substitute for medical examination or diagnosis and that it is recommended that I see a M.D. for any physical or mental ailment. I have stated all of my known medical conditions regarding my physical, mental, and emotional health. I attest that I understand the nature of shamanic treatment and freely elect to receive shamanic healing treatments, and thus, I release any and all claims of malpractice, non-disclosure, or lack of informed consent.