Coaching Agreement & Disclosure Statement Tap Your Power, LLC Craig Weiner, Personal & Business Coach Certified EFT/Matrix Reimprinting & META-Health Practitioner 360.661.6877 www.efttappingtraining.com Thank you for your interest in engaging Tap Your Power, LLC, doing business as EFT Tapping Training Institute (“Institute”), to provide the services of Craig Weiner, either in person or via distance by telephone, Video Zoom, Skype, or another electronic platform, whichever is applicable. The Institute is providing you with the following information so you can make an informed choice about your decision to engage the Institute to provide the services of Craig Weiner. Please read this information carefully and let Craig Weiner know if there is any part you do not understand. 1. COACHING SERVICES OFFERED In his coaching practice, Craig Weiner works with clients in a number of areas, including health issues, creating deeper more meaningful relationships, and manifesting greater success. He offers several innovative energy-based coaching and self-help methods, including Emotional Freedom Techniques (EFT), Matrix Reimprinting, and META-Health (collectively the “Energy Methods”). The focus of his work is to help his clients neutralize energetic disruptions which consistently manifest as negative emotions, limiting beliefs, habits, patterns, and/or physical discomfort. His intent is to support and mentor his clients in identifying and releasing areas of resistance that may be interfering with their thinking and ability to live a fulfilling and healthy life. Please be advised, you have the option of using any of the Energy Methods as part of your work with Craig Weiner. 2. THEORETICAL APPROACHES Energy Methods Energy Methods is a collective term used to refer to a variety of energy balancing techniques, approaches, methods, and assessments based on the use and modification of energy fields. The Energy Methods are designed to assess where the body’s energies are blocked or not in harmony and then unblock, correct, and balance the flow of these energies, thereby aligning the body’s energies to promote well-being. The Energy Methods are also intended to assess the energetic impact of how thoughts, beliefs, habits, and emotions can influence the health and well-being of an individual. The prevailing premise of the Energy Methods is that the flow and balance of the body’s electromagnetic and subtler energies are important for physical, mental, and emotional health, and for fostering well-being. For further information regarding the Energy Methods, please refer to the Additional Client Information & Office Policies document which is attached hereto and made part of this Agreement. Although the Energy Methods appear to have promising physical, mental, and emotional benefits and there is a growing amount of valid scientific research indicating that EFT meets the criteria to be considered an evidence-based technique, they have yet to be fully researched by the Western academic, medical, and psychological communities. Therefore, the Energy Methods are considered experimental and the extent of their effectiveness, as well as their risk and benefits, are not fully known. The Energy Methods are self- regulated and no state in the United States licenses practitioners of the Energy Methods and considers them to be complementary and alternative approaches. If you ever have questions or concerns about the nature of the theories and methods Craig Weiner uses, please feel free to ask him for further resources or references. 3. NATURE OF THE RELATIONSHIP WhileCraig Weiner is a Licensed Chiropractor in the State of Washington, you understand that the Institute is only providing his services as a Personal & Business Coach and his services are not part of his chiropractic practice. Further, you understand as a Personal & Business Coach, your relationship with Craig Weiner, is not to be construed as psychotherapy, psychological counseling, or any type of therapy, nor is it a substitute for these services. While there are some similarities between coaching and psychotherapy, they are very different activities. The purpose of psychotherapy is to alleviate psychological disorders and coaching is not appropriate for clients with psychological disorders. Coaching is a professional relationship in which the coach partners with the client to help the client meet specific, tangible goals. The coach will work with the client to define goals and strategies for meeting them, and to identify potential obstacles and ways to minimize or eliminate them. Coaching may address specific personal goals or projects, life balance, job performance and satisfaction or general conditions in the client’s life, health, business, or profession. 4. OUTCOME EXPECTATIONS/RISK & BENEFITS While it’s not possible to provide any guarantees regarding your goals, Craig Weiner will work with you to achieve the best possible results for you. Participation in coaching can result in a number of benefits to you, including improvement and/or resolution of the specific concerns that led you to seek help but working toward these benefits requires effort on your part. Most clients experience positive outcomes with their coaching sessions but it is unknown as to how you will personally respond to the Energy Methods. Craig Weiner will ask for your feedback and views on your coaching program, its progress, and other aspects and will expect you to respond openly and honestly. While the Energy Methods are considered gentle and non-invasive, it’s possible in your sessions, or on your own between sessions, to experience some physical discomfort or emotional distress that can be perceived as negative. It’s also possible to experience some emotional distress or physical discomfort related to overwhelming or stressful experiences you may have had earlier in your life. Unresolved memories may also surface and emotional material may continue to surface after a coaching session and give indication of other issues or incidents that may need to be addressed. You agree to promptly inform Craig Weiner if you experience any emotional distress and/or physical discomfort during a session or between sessions. If appropriate, Craig Weiner can help refer you to an appropriate professional health care provider for further assistance. In using the Energy Methods it’s possible that previously vivid or traumatic memories may fade which is a positive outcome. However, this could adversely impact your ability to provide legal testimony that carries the same emotional impact as prior to applying the Energy Methods regarding a traumatic incident. 5. OTHER IMPORTANT INFORMATION RE: ENERGY METHODS Please be advised the use of the Energy Methods are not intended to be substitutes for medical or psychological diagnosis and treatment and they do not replace the services of licensed health care professionals. You agree to consult with your health care provider for any specific health care problems and understand that Craig Weiner may suggest you contact your professional health care provider if he believes it’s advisable. In addition, you understand that any information shared during your session(s) is not to be considered a recommendation that you stop seeing any of your health care professionals or using prescribed medication, if any, without consulting with your health care professional, even if after a coaching session it appears and indicates that such medication or treatment is unnecessary. ACKNOWLEDGMENT AND CONSENT TO RECEIVE SERVICES By signing this document, you agree that Craig Weiner has disclosed to you sufficient information to enable you to decide to engage or not engage the Institute to provide his services. You have considered all of the above information and the attached Additional Client Information/Office Policies & Procedures document and have obtained whatever information or professional advice you deem necessary to make an informed decision. You understand that your consent to the nature of your coaching session(s) is given voluntarily, without coercion, and may be withdrawn at any time in the future. You represent that you are competent and able to understand the nature and consequences of the proposed coaching session(s) and agree to be personally responsible for the fees related thereto. You have discussed with Craig Weiner the nature of the services to be provided and you understand that he is offering his services solely as a Personal & Business Coach and your relationship with him is not to be construed as psychotherapy, psychological counseling, medical treatment, or any other type of therapy, nor is it a substitute for these services. Further, you understand Craig Weiner is only providing his services as an employee of Institute and he is not providing his services as an individual or sole proprietor. You understand the Energy Methods are relatively new approaches and the extent of their effectiveness, as well as their risks and benefits are not fully known. Therefore, you agree to assume and accept full responsibility for any and all risks associated with them. Further, you agree and understand this Agreement is intended to be a complete unconditional release of liability and assumption of risk to the greatest extent permitted by law. Any and all matters in dispute between the parties to this Agreement, whether arising from or relating to this Agreement itself, or arising from alleged extra-contractual facts prior to, during, or subsequent to this Agreement, including, without limitation, fraud, misrepresentation, negligence or any other alleged tort or violation of the contract, shall be governed by, construed, and enforced in accordance with the laws of State of Washington, without regard to conflicts of law doctrines and regardless of the legal theory upon which such matter is asserted. This Agreement shall be binding upon you and your heirs and legal representatives. By signing in the space provided below, you and your heirs and legal representatives knowingly, voluntarily, and intelligently assume these risks and agree to forever fully release, indemnify, hold harmless and defend Tap Your Power, LLC, its owners, members, employees, agents, representatives, consultants, volunteers, and others associated with Tap Your Power, LLC from and against any and all claims or liability, of whatsoever kind or nature, which you, or your heirs and legal representatives, may have for any loss, damage, or injury, including without limitation, physical, emotional, mental, legal, financial, or personal, arising out of or in connection with your coaching sessions(s) and the use of the Energy Methods. Client Email Client Name Date Client Signature If you are submitting this Coaching Agreement & Disclosure Statement electronically, typing your name in the space provided above will be considered your signature and constitute your acceptance and agreement of this Coaching Agreement & Disclosure Statement. This Coaching Agreement & Disclosure Statement becomes effective as of the date signed above. © 2019 Midge Murphy, all rights reserved. Any unauthorized use of this Coaching Agreement & Disclosure Statement other than by Tap Your Power, LLC is prohibited by federal law. No part of this document may be reproduced or transmitted in any form or by any means, including photocopying, for public and/or private use without permission in writing from Midge Murphy. www.midgemurphy.com Additional Client Information & Office Policies Attachment to Coaching Agreement & Disclosure Statement 2. THEORETICAL APPROACHES Emotional Freedom Techniques (EFT) EFT is considered an innovative energy-oriented healing and self-help technique based on the newly emerging field of energy psychology. EFT seeks to address imbalances within a person’s energy system, as well as the energetic influence of thoughts, beliefs, and emotions on the body. The prevailing premise of EFT is that the cause of all negative emotions is a disruption in the body’s energy system. It is believed that EFT helps clear these disruptions, thereby restoring the flow and balance of the body’s electromagnetic and more subtle energies. EFT uses the ancient Chinese meridian system with a gentle tapping procedure which stimulates designated meridian end points on the face and body while saying specific phrases and focusing on issues of emotional intensity in order to release the intensity and reframe the issues. In an EFT session, the client does the tapping on the client’s own body and the practitioner helps guide the session by instructing the client where to tap while saying specific phrases based on the issues that are being worked on. If you are having an in-person session and you are not able to “tap” for yourself, then Craig Weiner may need to “tap” for you. In such a rare event, he will ask for your permission prior to tapping on your body. Matrix Reimprinting Matrix Reimprinting is considered an extension of EFT; however, it differs from EFT since it’s based on the premise that the subtle energies are trapped in the energy field/matrix which surrounds each individual and not in the body-mind brain. The main premise behind Matrix Reimprinting is that when you have experienced a stressful or overwhelming life event, a fragmented part of yourself is frozen in that moment and remains in your energy field. A Matrix Reimprinting session is designed to provide resources for what was needed in events that are still affecting your life. The memory is still there, but the resources around it can change, giving you a different outlook or perspective on that memory or stressful/overwhelming life event. META-Health META-Health is described as an innovative health care methodology within the field of Complementary and Alternative Medicine intended to help clients experience overall health and well-being. It is designed to interpret physical and emotional discomfort and experiences in a bio-logical way. META-Health protocols are meant to find a client’s root-cause stressors, emotions, beliefs, and lifestyle choices that may be affecting the client’s health and well-being. If in a coaching session a client identifies physical or emotional discomfort, META-Health protocols can help trace the underlying emotions that may be triggering the client’s physical and emotional discomfort. Once identified, the goal of META-Health protocols is to empower the client’s self-healing and to help the client establish new habits and behaviors. You understand that Craig Weiner is not “diagnosing” or “treating” the physical body if your coaching session includes using META-Health protocols. Further, you understand there is a distinction between “healing” using META-Health protocols and the practice of medicine or any other licensed health care practice. 3. TRAINING AND EDUCATION Craig Weiner is an accredited certified EFT Master Trainer of Trainers and accredited certified advanced practitioner as approved by EFT International. He is a certified practitioner and trainer of Matrix Reimprinting as approved by the EFT Matrix Reimprinting Academy. He is also a certified META Health practitioner through META Health International. His education includes a doctorate of chiropractic degree from Life Chiropractic College West and a B.A. degree from Lafayette College. He serves as director of the EFT Tapping Training Institute and currently serves on the board for ACEP, the Association of Comprehensive Energy Psychology and on the EFT international Research Committee. 4. CONFIDENTIALITY Except as provided below, Craig Weiner will maintain your confidentiality and will not disclose any information you share with him during your coaching session(s) without your prior written permission. You may direct him to share information with whomever you choose and you can revoke that permission at any time. Craig Weiner will break confidentiality if he believes you may harm yourself or another, if he is required to do so by law such as a court order or to report abuse or neglect of a child, dependent, or older adult. Further, please be advised that if any communication regarding your sessions is conducted over Zoom, Skype, phone (voice or text), email, or other electronic platform, it is not possible to guarantee the confidentiality of the information contained in any of these electronic communications. 5. PACKAGES & FEES The Investing in Myself Package ($1,250) – Initial 45-minute Discovery Session followed by six 60-minute The Going Deep Package ($1,995) – Initial 30-minute Discovery Session followed by ten 60-minute Follow Up (Post-Initial Package) Private Session ($200) for a 60-minute For EFT Tapping Training Institute mentees only ($525) – Three 60-minute 6. PAYMENT POLICIES Packages and individual private sessions can be purchased by check, credit card or via PayPal. This Coaching Agreement must be signed and payment must be received at least 48 hours in advance of the Initial Discovery Session. If this Coaching Agreement and payment are not received at least 48 hours in advance, then the initial Discovery Session must be rescheduled. Payment is expected prior to an individual private session appointment, unless previous arrangements have been made. Package sessions must be used within 12 months from date of purchase. Any Package session not used within 12 months from the date of purchase will be forfeited and no refunds will be given for any unused sessions in a Package. 7. DISCONTINUATION OF SERVICES At any time during your coaching sessions with Craig Weiner, he will notify you if he determines, in his sole discretion, that your concerns, history, or request for his services falls outside what he feels is his scope of practice or skillset. In such an event, Craig Weiner will consult and discuss with you regarding potential collaborative care or refer you to another appropriate professional. Any fees paid in advance by you will be prorated and the fees for any remaining sessions will be refunded to you. 8. CANCELLATIONS Scheduling of appointments involves the reservation of time specifically for you. Therefore, once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours’ advance notice of cancellation. If you miss a session without canceling, or cancel with less than 24 hours’ notice, then you will forfeit the funds for that session with the exception of emergency situations which will be discussed on an individual basis. 9. COMMUNICATION Any communication between sessions, including a need to cancel or reschedule an appointment should be done via email and sent to craig@efttappingtraining.com.
