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Disclosure Statement

Welcome to my practice. I am a practitioner/master/teacher of reiki and energy therapy (also called energy healing or energy work) and spiritual healing. I am not a licensed physician, nor are energy healing and spiritual healing services licensed. In order to use my services, it is required that you acknowledge receipt of the information provided in this form and that you sign it. You will receive a copy. I will keep the original in my records for at least three years.

The idea behind energy therapy is that:

Underlying the functioning of the physical body is the “human energy field" which governs all aspects of our functioning – physical, mental, psychological, emotional and spiritual.  Increasing the balance, coherence and creating the proper flow of energy in the energy field helps to support the functioning of the body, mind, and emotions, as well as enhance the spiritual life. Energy healing can thus help support the self-healing capacity of the body and mind.

The idea behind spiritual healing is that:

Spiritual healing represents the idea that the most profound healing comes from a connection with our “spiritual essence” or a “higher power”.  Whether we call it “God”, “Wholeness”, “Spirit” – whatever the name - spiritual healing helps to strengthen our connection with that greater power or Source from which healing comes.  This comes about through the mutual understanding and intention of the healer and client.  In spiritual healing, the practitioner recognizes “Spirit” as the healer, and sets aside the individual will, acting as a conduit for spiritual energies and assistance.

As a practitioner of energy healing and spiritual healing, I will provide you with the following kinds of services, depending on your needs and preferences:

* Assessment of treatment needs based on intuitive assessment of the "energy field" or "aura".

* Assistance in clarifying your intention for healing and preparation to receive maximum benefit from the healing session.

* Energy therapy involving interventions to alter the flow and pattern on energy within the energy field and body. Spiritual healing with a special  focus on the spiritual aspects of healing and/or the intention for spiritual deepening.

* Education about energy healing and caring for oneself as an "energetic being".

* Lifestyle and/or spiritual counselling based on the interpretations of energetic findings.

* Referral to other practitioners, when appropriate.

I have been practising various healing arts, including, meditation instruction, spiritual mentoring and energy healing.  I began practising hands-on energy healing 4 years ago.  My studies include not only formal training in energy healing, but also training in meditation, counselling and spiritual development which contribute to the skills I bring to my practice.  Much of my skill in energy healing has been developed through self-study.  Many of the techniques I use have been developed in the course of my healing work, and I have formulated a method of teaching energy healing called Spirit Connection Energy Healing.  My more formal healing-related training and education are described below:

Master of The Isis Blue Moon Healing System
Grand Master Level 6 of Usui Shiki Reiki Ryoho
Master of Kundalini Reiki
Master of Ahara Reiki
Master of Ra- Sheeba
Master of YOD
Master of The Egyptian Cartouche
Angelic Empowerments Facilitator

My method of treatment, energy healing and spiritual healing, is alternative or complementary to the healing arts that I offer you, these services are, subject to the following requirements and restrictions.

Unlicensed alternative practitioners are NOT allowed to:
* Perform any form of surgery or any procedure that punctures your skin or harmfully invades your body.

* Use X-ray radiation.

* Prescribe prescription drugs or recommend that you discontinue drugs that were prescribed by a licensed physician.

* Set fractures.

* Treat wounds with electrotherapy.

* Put you at risk of great bodily harm, serious physical or mental illness, or death.

* Imply in any way that they are licensed physicians.

If you ever have any concerns about the nature of your treatment, please feel free to discuss them with me.  I recommend that you inform your medical doctor that you are receiving energy healing treatment.

Acknowledgement and Consent to Receive Services:
I have read and understand the above disclosure about the energy therapy and spiritual healing treatment offered by Deborah Bell and Deborah’s training and education.   I have asked Deborah questions I have about the nature of the services to be provided and have consented to use the services.  I understand that Deborah is not a licensed physician and that Deborah’s services are not licensed.  I understand it is my responsibility to maintain a relationship for myself/my child with a medical doctor. 

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 Signed: ___________________________                Date: 

__________________________________
(client/parent/conservator/guardian)
Indicate capacity to sign if other than client _______________________

                                                                                   

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