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
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One-on-one personal and professional development coaching
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Goal setting and achievement strategies
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Life transition support
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Career development guidance
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Performance enhancement coaching
Hypnosis Services
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Stress management
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Habit modification
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Confidence building
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Motivation enhancement
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Pain management support
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Relaxation techniques
Understanding Our Role
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We are coaches and hypnosis practitioners, not licensed therapists or medical professionals
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We cannot diagnose or treat medical or mental health conditions
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Our services complement, but do not replace, professional medical care
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We maintain appropriate professional boundaries at all times
Your Rights
You have the right to:
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Ask questions about any aspect of our services
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Decline any suggestion or technique
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End any session or the professional relationship at any time
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Request referrals to other professionals
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Confidentiality within legal limits
Health and Safety
Medical Clearance
Consult your healthcare provider before starting our services if you:
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Have any medical conditions
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Are taking prescription medications
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Are pregnant or nursing
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Have mental health concerns
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Have recently experienced trauma
Hypnosis Contraindications
Do not participate in hypnosis if you have:
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Acute psychiatric conditions
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Uncontrolled seizure disorders
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Severe clinical depression
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Active substance abuse issues
We cannot provide services to individuals diagnosed with:
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Bipolar Disorder
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Borderline Personality Disorder (BPD)
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Schizophrenia
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Other diagnosed mood disorders
This policy exists because:
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These conditions require specialized medical care
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Our services may impact treatment outcomes
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Results of coaching/hypnosis may be unpredictable
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Your safety and wellbeing are our top priority
Session Information
Format Options
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In-person sessions
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Video conferencing
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Phone consultations
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Email support
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Text message support (scheduling only)
Duration and Frequency
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Standard sessions: 90 minutes
Financial Terms
Payment
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All fees due before service delivery
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Accepted methods: Debit, Credit Cards, Cash, E-transfer
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E-transfer to: support@wellnesscanada.ca
Cancellation Policy
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24-hour notice required for cancellation
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Late cancellations billed at 50% of session fee
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No-shows billed at full session rate
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Emergencies handled on case-by-case basis
Refund Policy
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No refunds for completed sessions
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Package refunds prorated minus completed sessions at individual session rate
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Administrative fee may apply to refunds
Confidentiality
We protect your privacy with these exceptions:
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Risk of harm to self or others
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Suspected abuse of children or vulnerable adults
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Court order or legal requirement
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Collection of unpaid fees
Practitioner Commitment
We commit to:
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Maintain professional ethics
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Provide service within our scope of practice
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Keep accurate records
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Maintain appropriate insurance
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Pursue ongoing professional development
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Make appropriate referrals when needed
Client Agreement
By signing, I acknowledge:
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I have read and understand this document
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I am over 18 or have guardian consent
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I am not using these services to replace medical care
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I understand the scope and limitations of services
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I agree to the financial terms
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I understand the confidentiality policy
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I am participating voluntarily
Contact Information
Wellness Canada
157 High Street Georgina, Ontario, L0E 1R0
support@wellnesscanada.ca
