This document contains important information about my professional services and business policies. It covers a wide range of possible situations, some of which may not apply to you. Still, it provides a framework for understanding the services you are considering. Please read it carefully and note any questions you might have. We can discuss them at our next meeting. If you decide to use my services and sign this document on the signature page, it will represent an agreement between us.
EDUCATION, TRAINING & APPROACH
I am the owner of Life in Balance Ayurvedic Rejuvenation Center. I have been practicing alternative healing therapies and energy medicine for over 20 years. I am an Ayurvedic Doctor Level Certified through NAMA and Accredited Certified EFT Practitioner through EFT International.
My work focuses on the integral connection between the mind, body, spirit and emotions. I integrate the ancient wisdom of Ayurvedic with EFT Tapping. Each session will include coaching and the introduction and experience of new practices and principles, which include; diet, dinacharya (daily routine), herbs, meditation, EFT (Emotional Freedom Techniques), energy/chakra work, Pranayama (breathing exercises), sound healing, cleansing & rejuvenation practices. There is a loose structure for the program, allowing the process to unfold organically based on your individual needs and progression towards your vision. When we trust and follow our intuition, magical and unforeseen results manifest.
I have found that EFT Tapping effectively supports physical and emotional healing by getting at the deep emotional root of the issue. I am committed to bringing my clients to the place of experiencing love and acceptance for themselves and living joyfully; awake and fulfilled in the difference they make in their communities and the world.
WHAT IS AYURVEDA?
Ayurveda, the science of life and longevity, is a system of understanding the body that has been practiced for more than five thousand years. It blends ancient wisdom with practical science to support how you live, eat, rest, and move through your day. The focus is not on treating disease, it is on caring for the individual person and guiding them back to their natural state of balance. Ayurveda is a self-healing science and unfolds through understanding one’s own unique nature and applying the principles of balance in your life. In Ayurveda, true health includes a clear mind, a steady body, and a sense of inner joy.
WHAT IS EFT (EMOITONAL FREEDOM TECHNIQUES) TAPPING?
EFT is an approach that involves balancing and restoring your body’s natural energies for the purposes of increasing your vitality, strengthening your mental capacities, and optimizing your health. The form I use is Clinical EFT, the method validated in many research studies which shows it to be an evidence-based practice. Gentle tapping stimulation of Marma Points located on the surface of the face and body, paired with mental activation of unwanted emotional content or desired outcomes can shift the brain’s electrochemistry to:
• help overcome anxiousness, fear, guilt, shame, jealousy, or anger
• change unwanted habits and behaviors
• replace negative thoughts with life enhancing ones
• relieve the emotional contributors to physical pain
• enhance the ability to love, succeed, and enjoy life.
Tapping gently on specific Marma Points (energy points) on the face and body for physical and emotional issues are intended to complement, not replace, medical or psychological care. Results will vary from person to person.
• The intensity of previously vivid or traumatic memories may diminish. This could adversely impact the ability to provide legal testimony regarding a traumatic incident
• Reactions may surface during sessions that are unanticipated, including strong emotional or physical sensations or additional unresolved memories
• Emotional material may continue to surface after a session and give indication of other incidents that may need to be addressed
The EFT techniques I will be using and teaching you are based on the premise that by promoting balance and flow in the body’s electromagnetic and subtle energies, health and well-being are enhanced. The methods we will be using lend themselves to individualized applications in the office, via Zoom and at home for personal work and self-care. EFT is a self-regulating technique or self-help tool that you can use whenever and wherever you choose, and you are not dependent on another person to practice it successfully.
SESSIONS
The DIYL Program includes 10 Session over a 3-month period. Our initial session is 1.5 hours and includes a full Ayurvedic Consultation to determine your unique constitution and establish your intentions and goals for our work together. The next 9-Sessions are 60-minute duration. In general, weekly sessions are scheduled, at a time we agree upon, for 3 consecutive weeks and then one week off for integration. Sessions may also, by prior agreement, be more frequent, or less frequent. Your schedule will be determined by what we agree upon for duration and frequency and can be changed ahead of time to account for vacation. Although this is considered a 3-month Program, due to vacation, unforeseen circumstances or participation in Seasonal Ayurvedic Cleanse, may extend longer. Program sessions must be complete within 5-months from the start date, or sessions will be forfeited.
PROFESSIONAL RECORDS
I keep records on each session, primarily noting the date of the session, the techniques used and progress or obstacles observed as they relate to your goals in working with me. I maintain your records in a secure location. I may maintain your records for three years after our last contact, after which time I may securely dispose of them.
CONFIDENTIALITY AND CLIENT RIGHTS
You have the right to the confidentiality of your therapy.
- I will not tell anyone else what you have told me, or even that you are working with me, without your prior written permission.
- Your confidentiality is also protected under provisions of the Federal Health Insurance Portability and Accountability Act (HIPAA), which are discussed in the Notice of Privacy Practices form that I have asked you to read and sign in addition to this form.
Our communications are confidential. No information will be given to anyone without your explicit written consent. Exceptions to confidentiality include the following:
- My participation in mentor/professional consultation for further development. In these consultations, your identity will not be revealed and the consultant is also bound to keep the information confidential.
- If I believe that you may be a danger to yourself or others, I will do whatever I can to try to prevent harm.
- If you tell me about the knowledge or suspicion of abuse of minors, developmentally disabled people, or dependent elders, I must report it.
- If a court requires me to disclose information, I must comply with the court order.
- If you tell me about the unprofessional conduct (e.g., sexual misconduct) or impaired judgment of a health care professional, I must report it.
- If one of these conditions exists, I will try to talk with you before contacting the relevant authorities.
PROFESSIONAL FEES & PAYMENT
Initial Session runs 90 minutes.
Following 9-Sessions run 60 minutes.
Payment may be made by credit card, Venmo, PayPal or Check. The Program is $1795 when paid in full or 3 payments monthly for $650 set up for automatic monthly withdraw. Venmo payments @kael-balizer. PayPal email address:
info@ayurvedaseattle.com
Once you commit to the DIYL Program, the full cost of the Program is non-refundable.
SCHEDULING & CANCELLATION POLICY
I check my email and voicemail on my workdays -- Mondays, Wednesdays, and Thursdays. We can schedule appointments during our appointments, by e-mail or you can schedule on my website. If you can’t attend an appointment, please let me know by email or phone, ideally with at least 48 hours’ notice, so that I can offer the spot to another client. If you cancel your appointment with less than 24 hours’ notice you will forfeit the full session, with the exception of if you become sick or there are unusual circumstances beyond your control. If you are late for an appointment, we will probably have a more limited time to meet.
QUESTIONS & SUPPORT BETWEEN SESSIONS
If you have questions or need support between sessions, please email me and I will be happy to respond to your email and send suggestions. As your partner on this journey, I love to hear breakthroughs, wins and challenges along the way. Email communication is encouraged between sessions. Don’t do this alone. If you need further support before our next session, I will gladly move our session up to the next available session.
TERMINATING THE SESSION
If I determine that I am unable, for any reason, to provide you with the services you are requesting at a high professional standard, I will inform you of this decision and refer you to another practitioner, or to a health care provider who may better meet your needs. Second, if you verbally or physically threaten or harass me, I reserve the right to terminate you from my practice immediately and unilaterally. Third, I reserve the right to refuse or terminate a session if you are suspected of being under the influence of a mood-altering substance. You will be responsible and this will be considered a full session.
VACATIONS
I am away from the office several times each year for vacations, or to teach. I will make every effort to tell you well in advance of any anticipated lengthy absences and to discuss other options for continuing to work toward your goals during my absence.
COMPLAINTS
If you are unhappy with the way our work together is proceeding, or if I ever say or do something that upsets you or doesn't feel right, you agree to bring it up and talk about it with me so I can respond directly to your concerns. I will take such concerns seriously and meet them with care and respect.
CLIENT/COACH AGREEMENT
Many of my policies and procedures are cited in the Informed Consent document above but below explains a little bit more about what I expect of you as a client so that there are no misunderstandings of how we will be working together.
In the text below, the term "client" refers to you and the term "coach" refers to Kael Balizer. If there is anything you do not fully understand in any part of this document, please ask me about it so that we may begin our relationship in an open, honest manner.
1. As a client, I understand that Kael Balizer is an Ayurvedic Doctor Level Certified through NAMA and an Emotional Freedom Techniques (EFT) Coach, not a medical professional, physician or therapist and is not licensed to diagnose or treat any physical or mental illness. Although EFT uses the term “emotional,” it does not imply that EFT practitioners are practicing therapy.
2. I understand and agree to meet my coach at the scheduled time. I will come to the call/Zoom meeting with updates, progress and current challenges and will let my coach know what I want to work on and be ready to be coached. I understand that the agenda is client-generated and coach-supported.
3. As a client, I understand and agree that I am fully responsible for my well-being during and between my coaching sessions, including my choices and decisions. I recognize that coaching is not psychotherapy and that professional referrals will be given if needed.
4. I understand that "Ayurvedic Coaching" is a relationship I have with my coach that is designed to facilitate the creations/development of health, personal, professional or business goals and to develop and carry out a strategy/plan for achieving those goals. I acknowledge that deciding how to handle these issues and implement my choices is exclusively my responsibility.
5. I understand that Ayurvedic and EFT coaching does not treat mental disorders as defined by the American Psychiatric Association. I understand that coaching is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment; and I will not use it in place of any form of therapy.
6. I promise that if I am currently in therapy or otherwise under the care of a mental health professional that I have consulted with this person regarding the advisability of working with an EFT coach and that this person is aware of my decision to proceed with the EFT coaching relationship. Likewise, I have advised my coach of any kind of mental health or physical treatments under a doctor that I may currently be involved in.
7. I understand that any information discussed with Coach/Practitioner will be kept in strict confidence, except as released by client, and accept as required by law and discussed previously in this document. Coach may ask to audio record sessions for transcription and ease of delivering notes after sessions. You may decline audio recordings if you’re not comfortable. Certain topics may be anonymously shared with other professionals for training or consultation purposes.
8. I or my representative(s) agree to fully release and hold harmless Kael Balizer from and against any and all claims or liability of whatsoever kind or nature, real and implied, arising out of or in connection with my sessions.
Your signature below indicates that you have read the information in all sections of this document, understand the content fully, have discussed any questions or matters of concern with me and/or others, and agree to abide by its terms during our professional relationship.
By signing this form I agree to the terns and conditions of this agreement.