Client Agreement English

(If you meet in person in Norway with Jon Harald Gjesdal, you can either print this agreement and fill in or you can get this sheet once you get there. If Skype, it is enough if you read the agreement.)

 

My name is Jon Harald Gjesdal, I am a therapist who works to get clients let go of stress and help create changes. I have studied alternative techniques and will use these to provide therapy. FasterEFT and psychosynthesis will be the techniques I use in a individual therapy session. I am trained as a speech therapist in psychosynthesis at Huma Nova in Oslo. Information given by the client to Jon Harald Gjesdal is confidential.

I’m not a psychologist, medical doctor or educated in diet and I have no license or formal training in any of these fields.

EFT techniques that are used in our hours are not intended to represent the “tapping ” to be used to diagnose, treat, cure or prevent diseases or mental disorders. EFT techniques does not guarantee short-term or long-term good results. “Tapping” is used in class is not a replacement for medical or psychological problems. In addition; the information or the treatment given during class is not intended as a recommendation to stop to go to professional treatment in the health of any kind, nor intended as recommendation to stop using prescribed medication. If changes are to be made must be discussed with medical professionals such as a doctor.

 

I, ___________________________________________, agree that Jon Harald Gjesdal as an alternative therapist to meet me. I will even take full responsibility for how I use these techniques. I take full responsibility for everything that will happen during and after hour / hours, as a result of this session or future hours. I understand and agree that Jon Harald Gjesdal is not responsible for how I use these techniques as I learn in class. I do not hold Jon Harald Gjesdal responsible for treatment I might need outside of these hours, nor in the future. I will consult with professional medical health professionals or other professional support staff I currently go to, before I start the lessons with Jon Harald Gjesdal.

I, ____________________________________________, take full responsibility for my life, my health and my well-being now and in the future. Everything that happens in class is confidential. I accept that I anytime is free to stop doing sessions and to stop seeing Jon Harald Gjesdal.

There is 48-hour deadline to cancel an hour. Cancellation of hours that are not paid within the time limit, has to be paid for. This is because it will be difficult for Jon Harald Gjesdal to acquire new clients on short notice to fill canceled hours.

Once I leave hours / hours, I take full responsibility for any kind of possible choices that could harm me. I also take fully responsible for all treatment and follow-up.

 

Name________________________________________________________________

 

Signature__________________________________________________________ Date: ___________________

 

Possibly Guardian: ____________________________________________________Date: ____________________

 

Phone: _____________________________________

 

E-mail: ______________________________________________ @ _______________________

 

 

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