Holistic healthcare practitioners are trained specialists who use non-invasive holistic practices to create a healthy environment for the mind, body and spirit. Holistic healthcare practitioners are NOT Medical Doctors (MDs).

By booking an appointment I acknowledge that the services I wish to receive are those of a holistic nature and do not serve as a substitute for other professional medical advice, examination, diagnosis or treatment. I have, following consultation, consideration and discussion, agreed to undergo this therapy, and thereby authorize Kea Charmak to perform services to develop a natural, complementary health improvement program for me in order to assist me in improving my overall health and not for the treatment or “cure” of any disease.

I understand that the services rendered are safe, non-invasive holistic methods of balancing the body’s physical, emotional, and nutritional needs and those imbalances can cause or contribute to various health problems.

I understand, that it may take several sessions before I notice any benefit. This will depend on my life style, on-going medication and general health.

I also recognize that on occasion this treatment may result in the release of traumatic, stressful, or negative feelings that have been previously suppressed.

I acknowledge that I have given my personal details for the holistic provider’s use. I understand that my information is protected and I give my consent for Kea Charmak to store and use my details. I understand that if I have been untruthful with my details or have failed to give enough relevant information any treatment could be adversely affected. I also understand that Kea Charmak, on its discretion may under extreme circumstances elect to release pertinent information in order to ensure the health and welfare of myself and/or others.

I understand that I should continue to see any medical doctors I am currently under the care of, and that any prescription medication should not be altered without first consulting the Doctor who prescribed the medication. In the case of a medical emergency, medical ailment or in respect to general health questions, I will seek the appropriate medical treatment.

Nothing said, done, typed, printed or reproduced by Kea Charmak is intended to diagnose, prescribe, treat or take the place of a licensed physician or counselor. I am a willing participant in Kea Charmak’s holistic program.

I understand that on occasion, it may be recommended that I use a particular supplement or other product to assist in my treatment for the intention of releasing energetic blockages that may be affecting my wellness and balance. Use of these supplements or products should be used at the sole discretion of the client with the advice and consent of their medical provider.

I understand Kea Charmak is a facilitator of holistic healthcare and when necessary may connect clients to other holistic healthcare providers. I understand that, Kea Charmak operate pursuant to ORS 675.715 to 675.835 in that she does not meet the requirements of ORS 675.715 (1)(b); or does not practice: Marriage and family therapy as defined in ORS 675.705 (6)(a); or Professional counseling as defined in ORS 675.705 (7)(a).

By scheduling and paying for an appointment, I accept these terms.