Consent for Service

This document outlines the nature of our professional relationship, your rights, and our responsibilities.
Please read carefully before signing.
 

Services We Provide
 

Coaching Services
 

• One-on-one personal and professional development coaching

• Goal setting and achievement strategies

• Life transition support

• Career development guidance

• Performance enhancement coaching
   

Hypnosis Services
 

• Stress management

• Habit modification

• Confidence building

• Motivation enhancement

• Pain management support

• Relaxation techniques
   

Understanding Our Role
 

1. We are coaches and hypnosis practitioners, not licensed therapists or medical professionals

2. We cannot diagnose or treat medical or mental health conditions

3. Our services complement, but do not replace, professional medical care

4. We maintain appropriate professional boundaries at all times

Your Rights
 

You have the right to:
 

• Ask questions about any aspect of our services

• Decline any suggestion or technique

• End any session or the professional relationship at any time

• Request referrals to other professionals

• Confidentiality within legal limits
   

Health and Safety
 

Medical Clearance
 

Consult your healthcare provider before starting our services if you:
 

• Have any medical conditions

• Are taking prescription medications

• Are pregnant or nursing

• Have mental health concerns

• Have recently experienced trauma
   

Hypnosis Contraindications
 

Do not participate in hypnosis if you have:
 

• Acute psychiatric conditions

• Uncontrolled seizure disorders

• Severe clinical depression

• Active substance abuse issues
   

We cannot provide services to individuals diagnosed with:

​

• Bipolar Disorder

• Borderline Personality Disorder (BPD)

• Schizophrenia

• Other diagnosed mood disorders
   

This policy exists because:
​

• These conditions require specialized medical care

• Our services may impact treatment outcomes

• Results of coaching/hypnosis may be unpredictable

• Your safety and wellbeing are our top priority
   

Session Information
 

Format Options
 

• In-person sessions

• Video conferencing

• Phone consultations

• Email support

• Text message support (scheduling only)
   

Duration and Frequency
 

• Standard sessions: 90 minutes
   

Financial Terms
 

Payment
 

• All fees due before service delivery

• Accepted methods: Debit, Credit Cards, Cash, E-transfer

• E-transfer to: support@wellnesscanada.ca
   

Cancellation Policy
 

• 24-hour notice required for cancellation

• Late cancellations billed at 50% of session fee

• No-shows billed at full session rate

• Emergencies handled on case-by-case basis
   

Refund Policy
 

• No refunds for completed sessions

• Package refunds prorated minus completed sessions at individual session rate

• Administrative fee may apply to refunds
   

Confidentiality
 

We protect your privacy with these exceptions:
 

1. Risk of harm to self or others

2. Suspected abuse of children or vulnerable adults

3. Court order or legal requirement

4. Collection of unpaid fees
    

Practitioner Commitment
 

We commit to:
 

• Maintain professional ethics

• Provide service within our scope of practice

• Keep accurate records

• Maintain appropriate insurance

• Pursue ongoing professional development

• Make appropriate referrals when needed
   

Client Agreement
 

By signing, I acknowledge:
 

• I have read and understand this document

• I am over 18 or have guardian consent

• I am not using these services to replace medical care

• I understand the scope and limitations of services

• I agree to the financial terms

• I understand the confidentiality policy

• I am participating voluntarily
   

Contact Information
 

Wellness Canada
157 High Street Georgina, Ontario, L0E 1R0
support@wellnesscanada.ca