Welcome to My Practice

A Private Membership Association

This document provides important information regarding my professional services and business policies as offered through At the Heart of a Wise Practice Private Membership Association (the “Association” or “PMA”). By reviewing this information and choosing to participate, you are applying for membership in this private association. Membership is voluntary and limited to individuals who knowingly and willingly agree to the terms outlined herein.

Please review the entire document carefully. Feel free to bring any questions so that we may discuss them during your visit or prior to finalizing membership.

About the Private Membership Association

The Association is a private membership body formed under the protections of the United States Constitution, specifically the rights of free association, privacy, and private contract under common law. Services, guidance, and support are provided exclusively to members of the Association and are not offered to the general public.

As a member, you acknowledge that:

By becoming a member, I enter into a private contractual relationship under common law with the Association and its facilitator. I understand that all services are offered in the private domain and that I retain complete sovereignty and responsibility over my personal health and wellness decisions.

Membership is established by signing this agreement and paying any applicable one-time nominal membership fee (currently $50.00, which may be waived or included in the initial session at the facilitator’s discretion). Your signature confirms voluntary acceptance of the Association’s terms. The membership fee will be given back when and if the contract has ended.

I agree to indemnify and hold harmless the facilitator and the Association from any claims, liabilities, or damages arising from my participation, my health decisions, or the outcomes of the supportive services provided, except in cases of proven gross negligence or intentional misconduct.

This document provides important information regarding my professional services and business policies. Please review it carefully and feel free to bring any questions you may have so that we may discuss them during your visit.

About My Therapeutic Process and Integrated Rehabilitation Model

As a facilitator of integrative wellness practices, I bring more than forty years of dedicated study, clinical practice, and teaching in holistic approaches to health and well-being. This extensive experience encompasses manual therapies, movement re-education, energetic principles, nutritional considerations, and trauma-informed presence-based practices.

The facilitator does not diagnose, treat, cure, or prescribe for any medical condition. Members retain full personal responsibility for their health choices and decisions.

Manual therapy encompasses a variety of hands-on techniques designed to promote health and healing through the skilled application of the facilitator’s hands. I have received advanced training in multiple manual therapy and bodywork approaches, as well as therapeutic movement practices.

I incorporate principles from Traditional Chinese Medicine and other classical systems for health and wellness. When indicated, I offer nutritional intake suggestions and practical, sustainable strategies to support optimal healing and reduce inflammation in the body over the long term.

I provide trauma-informed support through attentive, genuine listening and presence to each member’s unfolding personal narrative. This includes gentle attention to experiences that may remain unmetabolized and unconsciously influence one’s life, thereby limiting the expression of one’s innate capacity for limitless movement and vitality.

All of these modalities are integrated within a comprehensive holistic framework aimed at supporting a strong, vibrant, and healthy life-body.

Benefits and Potential Effects of Manual Therapy

While manual therapy offers significant life-changing benefits, it also carries certain temporary risks. Following treatment, some individuals may experience temporary discomfort or minor soreness for one to three days as part of the healing process. It is also common to notice an increased awareness of emotions, memories, or thoughts as the body and mind integrate and move toward greater ownership of one’s health. There is a notion that our memories are stored in tissue. Oftentimes painful patterns in certain areas of the body may be reflective of this.

What to Expect in the First Session

During your initial session, we will discuss your personal health goals in detail. The first appointment consists of a comprehensive intake of your concerns and treatment within a 90-minute session. By the conclusion of this session, I will provide my initial impressions and recommendations regarding our potential work together. You are encouraged to evaluate this information, along with your own comfort level, to determine whether I am the right facilitator for you.

Supporting optimal health for oneself today requires a commitment of time, energy, and financial resources. Careful selection of a facilitator to wellness is important. My goal is to support you in finding the most appropriate care for your overall health needs.

Session Duration, Scheduling and Responsibilities

Following the initial session, subsequent appointments are typically scheduled for 75 to 90 minutes at a mutually agreed-upon time.

Please have on hand a set of your own cotton (minimally) double fitted, straight bed sheets and one pillow case and one large bath towel. Oils may become embedded in sheets. Lastly, I do this not for my own benefit, rather so that you have something familiar that can be reused with successive sessions if needed.

Cancellation and Payment Policy

Once an appointment is scheduled, you are responsible for full payment unless you provide at least 48 hours’ advance notice of cancellation, or we mutually agree that you were unable to attend due to circumstances beyond your control.

Payment is expected at the time of each session unless other arrangements have been agreed upon in advance.

My practice operates on a cash basis only. I do not accept insurance or third-party liability payments.

I maintain a limited sliding-scale option for members experiencing genuine financial hardship. If you have the financial means, I invite you to consider paying the full published rate. Doing so supports this community ethic and enables me to extend care to fellow members who are less fortunate. This practice reflects a shared commitment to mutual support and collective healing within our private membership association.

Professional Fees

Included

• Travel time to and from sessions, along with reasonable support through texting and phone conversations.
• Simple nutritional guidance, which may include a review of your kitchen inventory.
• Carefully selected, time-honored remedies and practices—drawn from old-world wisdom—that are tailored to your individual needs, supporting deeper connection to self and the world around you.

Guidelines Regarding Illness

I respect each individual’s need for safety and comfort. Please communicate any concerns regarding illness or health precautions so that we may ensure a positive and safe experience for both of us during our sessions.

If you have any symptoms of toxicity and inflammation in your body (e.g., cold or flu) take good care of yourself and we will reschedule for another time when health finds its way back.

Contact Information

Confidentiality

Communications between members and the practitioner within this Private Membership Association are treated with the highest regard for privacy and are considered private contractual and ministerial communications. In general, information shared will be held in confidence and released to others only with the member’s explicit written permission.

However, there are important exceptions required by law or professional ethics. Disclosure may occur without member consent in circumstances such as:

• A valid court order or subpoena;
• Situations involving imminent risk of serious harm to the member or others (duty to protect/warn);
• Suspected abuse or neglect of a child, elder, or dependent adult, where mandated reporting laws apply.

These exceptions reflect legal obligations that may supersede private agreements in specific public-safety contexts. Members are encouraged to discuss any questions or concerns about confidentiality during the initial session.

Acknowledgment and Membership Agreement

By signing below, I acknowledge and agree to the following:

• I have read and understand the information provided in this document, including the description of services, policies, fees, potential effects, and the private membership framework.
• I voluntarily apply for membership in At the Heart of a Wise Practice Private Membership Association and agree to abide by its terms.
• I understand that services are provided exclusively to members under a private contractual relationship and are not part of any public healthcare or insurance system.
• I accept full personal responsibility for my health decisions and acknowledge that the integrative care offered is intended to support my well-being within a holistic framework, not to diagnose, treat, or cure disease in the conventional medical sense.
• I have been given the opportunity to ask questions and have them answered to my satisfaction.
• I agree to the Professional Fees and Payment/Cancellation policies outlined above.

I further affirm my right to freedom of choice in matters of health and wellness and consent to participate in this private association.

A separate Your Information — Intake Form accompanies this agreement. Please complete and bring it to your first session.