I do not diagnose or treat medical or mental health disorders, nor am I trained or licensed to do so. The modalities that I employ (EFT, PTT. TTT, Belief Code, Body Code, Emotion Code) are energy psychology tools designed to optimize the body’s overall health and vitality but are not to be used instead of appropriate care from a licensed professional.

I am an Accredited Certified EFT Practitioner with EFT International with additional ‘Trauma Informed’ training. I am also certified in The Belief Code, The Body Code and The Emotion Code through Discover Healing.

If I recognize that am not qualified to help you with an issue you bring up, I will recommend you seek treatment with a qualified professional.

RESULTS – Any testimonials, examples, stories or information provided to you do not constitute a warranty, guarantee or prediction regarding the outcome of your use of any energy technique for any particular issue or purpose. People agreeing to the use of their testimonial have not received any material compensation.

SESSION – Unless we meet in person, we will be meeting on Zoom. I’ll send you an invitation with a link. I also ask you for a backup number so that we can continue the phone should we encounter technical difficulties. Please ensure you have privacy and will not be interrupted during your session. Also, I recommend that you have water available to stay hydrated.

CANCELLATION POLICY –at least 24 hours’ notice is necessary to cancel and reschedule and apply your payment to the next session. You can contact me at 919-490-1849 or sustainjane@gmail.com

CONFIDENTIALITY – Our sessions are confidential. I will take notes as we work together,but the information is stored safely and will not be disclosed. I will not tell anyone else what you have told me, or even that you are working with me without your prior written permission.

However, if there is immediate danger to yourself or someone else, I may have to share the information as appropriate. If this should occur, I will tell you.

EXCEPTIONS TO YOUR RIGHT TO CONFIDENTIALITY – There are some situations in which I am legally obligated to act to protect others from harm, even if I have to reveal some information about a client’s treatment. If I believe:
1. a child, an elderly person, or a disabled person being abused, I must file a report with the appropriate state or local agency.
2. a client is threatening serious bodily harm to another, I am required to take protective actions.
3. you are in imminent danger of harming yourself, I may legally break confidentiality and contact the police, a local crisis team, or a family member or other intimates.

I may occasionally find it helpful to consult other professionals about a client. During a consultation, I make every effort to avoid revealing the identity of the client. The consultant is also bound to keep the information confidential.

By continuing, you agree to fully release, indemnify, and hold harmless, Jane Norton, her heirs, personal representatives, consultants, employees and assigns from any claim or liability whatsoever and for any damage or injury, personal, financial, emotional psychological or otherwise, which you may incur arising at any time out of or in relation to your session(s). lf any court of law rules that any part of the Disclaimer is invalid, the Disclaimer stands as if those parts were struck out. By continuing to work with Jane Norton you agree to all the above.

MINORS – If you are under eighteen years of age, please be aware that the law may provide your parents or legal guardians the right to examine my records of our work together.Before giving them any information, I will discuss the matter with you. However, if I feel there is a high risk that you will seriously harm yourself or someone else, I will notify them of my concern.

*Clients 18 yrs and under must have their parent/guardian name typed in addition to theirs,granting permission in the space provided.

Except in the case of gross negligence or malpractice, I or my representative(s) agree to
fully release and hold harmless Jane Norton from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).

Note : By checking the box on the previous page, you agree to these terms.

Name: _______________________________________________ Date:__________________
Signed: ______________________________________________
Parent or Guardian Name: (if necessary) _______________________________________________
Signed: _____________________________________________