Ra Energy Healing - Consent Form
Practitioner Details
Name: Matthew Reilly
Business: Ra Energy Healing
Email: connect@raenergyhealing.com
Insurance: [Insurance Provider & Policy Number]
1. About Ra Energy Healing
Ra Energy healing is a complementary therapy that works with subtle energy to release tension, promote relaxation, emotional clarity, and energetic balance.
- Sessions may include hands-on or distance energy work, guided grounding, and reflection.
- Responses vary from person to person. Some clients feel warmth, tingling, calm, or mental clarity.
Important: Energy healing is not a substitute for medical care or psychological treatment. You should consult a doctor or other qualified healthcare professional for medical concerns.
2. Client Responsibilities
By attending a session, you confirm that:
- You have disclosed any relevant medical conditions, medications, or health concerns.
- You take responsibility for your own healthcare decisions.
- You understand the session is for wellbeing and support, not diagnosis or treatment.
3. Confidentiality
- All sessions are confidential.
- Information will only be shared if legally required (e.g., risk of serious harm).
- Notes may be kept for your personal progress and to comply with professional standards.
4. GDPR / Data Protection (UK)
- Your personal and health information is stored securely and used only for therapeutic purposes.
- Data will not be shared without your explicit consent, except as required by law.
- Records are retained for a minimum of 7 years.
- You have the right to access, correct, or request deletion of your data at any time.
5. Online / Hybrid Session Notice
- Online sessions are conducted via secure video platforms.
- You are responsible for being in a safe, private space.
- Sessions are not recorded without your consent.
- Technical issues may occur; backup communication is via email or phone.
6. Cancellation & Payment Policy
- Cancellation requires 24 hours’ notice (per booking platform agreement).
- Late cancellations or missed sessions may incur the full session fee.
- Payments are accepted via bank transfer, card, or booking platform.
- Packages are non-refundable but may be rescheduled with notice.
7. No Guarantees Clause
- Ra Energy Healing supports well-being, clarity, and energy balance.
- Individual experiences vary.
- No specific results or outcomes are guaranteed.
8. Safeguarding & Boundaries
- Sessions are not crisis intervention.
- You should contact emergency services, NHS 111, or a licensed healthcare provider for urgent concerns.
- The practitioner reserves the right to end a session if inappropriate behavior occurs.