Signing the acknowledgment below, you agree that I may treat your child. One of the various skills I use is hands-on energy healing, which helps to clear and charge the human energy field, remove energetic blocks that may lead to dis-ease, and enhance the body's natural healing capability. I will be doing energy work with my hands on the body and through the Human Energy Field (aura) that surrounds the body. Clients are fully clothed. They can be sitting or lying down.

I ask your child if they would like to participate before working on any movement, breathing, or energy work, and I honor their choice.

Another method I work with is a movement practice called Into the Body® to bring awareness and healing to the parts of yourself that have been shut down, frozen, or in deep pain. These exercises become a tool for your daily practice. They also help to integrate the work we have done in the sessions. This practice is done with comfortable clothes and guided movement.

Your child's sharing is always kept confidential. I will immediately share with you if your child is in danger. I do, however, talk about clients, without mentioning their names, with my professional supervisors for your safety and my continuing professional development (if needed). This is so that my clients may receive the most assistance available. If you prefer not to share, you can always let me know, and I will not bring your case to supervision.

I, the undersigned participant, affirm that I am the Parent or Guardian of this child, consent to treatment, and freely sign this agreement. I certify that I have read this agreement, fully understand its content, and that this release cannot be modified orally. I know this is a release of liability and a contract, and I am signing it of my own free will.

In partnership for healing and with warm regards,

Michelle Stone, Oonagh LLC

Healing Science & Energy Practitioner