Bodywork Agreement + Release of Liability Name * First Name Last Name Email * Bodywork Agreement + Release of Liability * *Purpose of Our Work Together* The work we share is rooted in reverence for the body and its wisdom. My practice offers women’s health bodywork including breast, belly, pelvic, fascia, jaw, and neck care. These sessions are intended to nurture connection, balance, and healing within the body. This work is not medical treatment or diagnosis. Each client is free to choose if and how they pursue medical evaluation, treatment, or other forms of care. *The Container* This space is held with respect, confidentiality, and care. You are invited to arrive as you are, with the freedom to voice needs, boundaries, or requests at any time. All parts of you are welcome here, and you always have the right to pause, decline, or adjust the session. *Your Responsibility* I honor your sovereignty and ask that you: •Take full responsibility for your own health, well-being, and choices. •Share openly any health history, physical conditions, injuries, or sensitivities that may influence our work. •Communicate with me during the session regarding comfort, sensation, or emotional experience. •Trust yourself as the ultimate guide for what feels safe, supportive, and aligned. *Informed Touch* I want you to know clearly that our work may include: •Gentle to deep touch in the areas of the belly, breasts, pelvis, jaw, and neck, as well as integrative fascia work. •Techniques that may bring physical, emotional, or energetic release. •The invitation, always, to say “yes” or “no” in each moment. Consent is ongoing and can be withdrawn at any time. *Health Intake & Confidentiality* For the sake of clarity and continuity of care, I may record details from your health intake form. These notes are kept securely and are for my reference only. At times, I may also seek guidance or support by sharing aspects of sessions in professional mentorship or practitioner community spaces. If I do so, your personal identity and details will always remain confidential and will never be shared. You have the right to decline having your information recorded or included (anonymously) in practitioner discussions. If this is a “no” for you, please let me know, and your choice will be fully respected. *Release of Liability* In choosing to receive this work, I understand and accept that: •My practitioner does not diagnose or treat medical conditions. •Decisions regarding medical care or treatment are mine alone to make. •No guarantees are made regarding outcomes, as each body and healing journey is unique. •I release Alexis Benning from liability for any outcomes I experience, and I take full responsibility for my body, my health, and my integration process. *Agreement* By checking the box below and signing my name, I acknowledge that I have read and understood this agreement. I enter into this work with awareness, responsibility, and consent. I agree Type your full name to sign * Cancellation + Reschedule Policy * •In honor of the time we both committed to, I hold a 48hr cancellation and reschedule policy: should you cancel or reschedule within 48hrs of our session, you will be charged 30% of the service cost. •If you no show, you forfeit the entire service cost. •Additionally, I reserve the right to withdraw service and/or cancel the participation of anyone at any time. In such cases, fees paid in advance will be pro-rated and refunded. I agree Thank you!