DISCLOSURE, TERMS & WAIVER

Services, Disclosure, and Referrals. As a practitioner, I offer integrated practices to support wellness of body, mind, and spirit. I am not a licensed mental health counselor or physician, and our work together should not replace the services, evaluation, and/or treatment provided by licensed health care practitioners. If in working together I feel that your needs are beyond my scope of experience, I will recommend that you seek the support of a licensed practitioner, and offer referrals when possible.

I understand that Breathwork is not intended to constitute medical advice or substitution for medical care, and that I am fully responsible for seeking medical help to treat all symptoms that are present before and after sessions with Breanna Doll.

Medical Disclaimer and Contraindications. Breathwork involves active connected breathing which can result in dramatic experiences accompanied by strong emotional and physiological responses, which can be physically, emotionally, or mentally provoking. Breathwork is not advised for persons with a history of cardiovascular disease, high blood pressure, epilepsy or seizures, glaucoma, bipolar disorder, schizophrenia, dissociative disorders, and during pregnancy. Modification may also be required if you have a history of severe trauma or PTSD, and it is your responsibility to inform me if any of these conditions apply to you so we can discuss options to best serve you.

I hereby state that I will inform Breanna Doll if any of the above conditions apply to me. I understand that I am solely responsible for seeking professional support after sessions if I feel physically, mentally, and/or emotionally unwell, and knowingly waive any claim I may have against Breanna Doll for injury or damages that I may sustain as a result from participating in sessions.

Touch. As a somatically-oriented practitioner, I may incorporate non-sexual touch in our work together. You may request that touch be initiated, adjusted, or ceased at any time, and have the right to decline or refuse to be touched without any fear or concern about reprisal. A few ways touch may be engaged in Breathwork sessions includes, but is not limited to:

• Using my hands to help direct breath awareness (placing hands on sternum, upper chest, side ribs, respiratory diaphragm, and abdomen)

• Using my hands to bring presence and encourage balanced, energetic flow (holding your feet, resting my hands on your shins, positioning hands on the front and back body, holding your head, etc.)

• Using my hands to offer counter resistance for your hands, arms, legs, rib cage, or other body parts to activate energetic flow in a specific region and increase the flow of breath

• Using my hands to offer comfort and support, such has a hand placed on your shoulder, arm, or heart

I understand that Breathwork sessions incorporate touch and that I can request that touch be offered, adjusted, or ceased at any time, and that I can decline any and all touch-based support.

Confidentiality and Consultation. I assure you that strong ethical standards of confidentiality are maintained, and that information shared in our sessions together is privileged communication. I regularly consult with other professionals and mentors to gain further knowledge and skill on how to best support my clients, and such discussions are done in a manner to maintain strict confidentiality. Please note that confidentiality may be waived (without consent) if there is reason to believe there is occurrence of child, elder, or dependent adult abuse or neglect, or if there is imminent danger to yourself or others.

Fees and Insurance. Payment is due at the time of booking, and I accept payment online by credit card, PayPal, or Venmo. I do not accept insurance, and it’s unlikely that Breathwork services will qualify for out-of-network care.

Cancellation Policy. If you must cancel or reschedule your appointment, you can do so via texting or email me directly (breanna@prismatic-breath.com) with a minimum of 24-hours notice (48-hours notice for in-person breathwork sessions). Unless due to an emergency, you will be responsible for the full session rate for missed sessions or cancellations with less than 24-hours notice (48-hours notice for in-person).

I understand that 24-hours notice must be provided for cancelation or rescheduling of my online sessions and 48-hours notice for in-person sessions, otherwise I will be responsible for the full session fee.

Feedback and Referrals. I welcome feedback about your experience working with me, and if you are not comfortable speaking directly, you are welcome to submit your feedback anonymously here. I welcome and appreciate your referrals.

Waiver of Liability. I, the Client, understand that Breathwork, psychospiritual guidance, and mindfulness-based inquiry are modalities that do not substitute or replace regular medical advice, examination, or treatment. I understand that Breathwork is not licensed or regulated by a governing body and that practitioners do not diagnose disease, prescribe any drugs or medications, make any health claims, or guarantee specific outcomes. I understand that it is my responsibility to see a licensed physician or mental health counselor to treat physical and psychological symptoms that are present before or after sessions with Breanna Doll. I understand that I am participating in a process that can potentially aggravate physical and psychological conditions, and knowingly assume the risk of injury or elect to participate in spite of risks, known and unknown.

I, on behalf of myself, my relatives, heirs, legal representatives, and assigns, agree thereby state that I am physically and mentally fit to participate in Breathwork. I knowingly and voluntarily waive any claim I may have against Breanna Doll for injury or damages that I may sustain as a result of participating in these activities. I have read this disclosure and waiver of liability and fully understand its contents.