🌸 Client Consent Form

✨ Purpose of Services

Emotion Code®, Body Code™, Belief Code®, and L.I.F.E. Biofeedback sessions are complementary wellness services intended to support relaxation, self-awareness, and energetic balance.

These services are not a substitute for medical care, mental health care, diagnosis, or treatment.
You are encouraged to seek licensed medical or psychological support for any health concerns..

🌿 Nature of Sessions

Sessions may include:

  • Gentle questioning and discussion

  • Muscle testing (in person or proxy)

  • Visualization and intention-based techniques

  • Biofeedback scanning using the L.I.F.E. System (in person or remote)

The goal is to identify and release energetic patterns that may be contributing to stress or imbalance.

🌼 Potential Benefits

Clients may experience:

  • Increased sense of well-being

  • Greater emotional clarity

  • Relaxation and stress reduction

Benefits vary by individual.

⚖️ Risks & Limitations

  • Possible experiences may include:

    • Temporary emotional release

    • Fatigue or mild discomfort

    • No noticeable change

    Results are not guaranteed.
    These services do not diagnose, treat, cure, or prevent disease.

🌿Alternatives

You may choose:

  • Not to participate

  • To pursue other complementary services

  • To seek licensed medical or mental health care

🔒 Confidentiality

All client information and session notes are kept confidential and will not be shared without written permission, except as required by law.

🌼 Voluntary Participation

Your participation is voluntary. You may pause or discontinue a session at any time.

👩‍👧 Minors

Clients under age 18 must have the consent of a parent or legal guardian, in accordance with Washington state law.

✅ Release of Liability

By signing below, you acknowledge that you understand the nature of these services and voluntarily assume full responsibility for your participation.
You agree to release and hold harmless Life Line Bioenergetics and practitioner Mihaela (Ane) Iukovici from any liability related to your participation.

✅ Acknowledgment

I understand these services are educational and wellness-oriented in nature. I understand it is my responsibility to maintain appropriate medical care. I have read and understood this consent form and have had the opportunity to ask questions.

✅ Agreement

By booking a session, you confirm that you have read, understood, and agree to the above terms.

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