Raindrop Technique Informed Consent Form

 

I Hereby Attest to the Following

1. I understand Rev. Nancy Gouch, BCRS, FCCI, LSH is a licensed spiritual healer qualified to help me accept Divine healing on every level of my being according to my faith and beliefs. I also understand Rev. Nancy Gouch, is able to help me recognize, address and heal my own spiritual imbalance that is manifesting as a physical, emotional, mental or psychological dis-ease or condition.

2. I also understand Rev. Nancy Gouch is a Board Certified Raindrop Specialist (BCRS) who uses Raindrop Technique to help me relax and manage my stress and pain, enhance the quality of my life, detoxify my body from the toxic pollutants I unintentionally eat, drink, absorb or inhale and help me improve my peak performance in my work, hobbies and other facets of my life. Raindrop Technique is a non-secular (spiritual) art and science.

3. I further understand Rev. Nancy Gouch is a Fully Certified Instructor (FCCI) for the Center for Aromatherapy Research & Education (CARE International) who is qualified to provide education in the science and application of essential oils so I may learn to relax and manage my stress and pain, enhance the quality of my life, detoxify my body from toxic pollutants and help me improve my peak performance.

4. I understand that I am responsible for my own health, healing and well being; and that Rev. Nancy Gouch cannot diagnose, treat, heal or cure me of anything. I also understand I have the ability to heal myself by taking care of my body, resolving my emotional issues, changing my thinking, believing my intuitive insights, surrendering to the Creator of all things, and accepting Divine healing. I further understand it is my responsibility to advise Rev. Nancy Gouch of any medications I take, any therapies I am undertaking, and any allergies or sensitivities I have. I further understand alternative healing is not a substitute for adequate medical care and I intend to remain under the care of my primary healthcare provider.

5. I understand that Raindrop Technique stimulates detoxification of the body. Therefore, it is crucial for me to drink plenty of water following a session and avoid toxic fluids such as soda pop, coffee, or alcohol. For the vast majority of Raindrop clients their experience is a pleasant sense of improved wellbeing, relaxation, and peak performance.

6. I further understand that Strong Emotional Releases can occur with Raindrop since the oils, when inhaled, go directly to the central brain which coordinates the memory of stored emotions. The oils also go directly to muscles, tissues and organs throughout the body where emotions can also be stored in cellular memory. Essential oils can penetrate cellular membranes and release these forgotten emotions.

7. I understand that Raindrop Technique is a complete modality that reaches to all levels of the body, mind and emotions. I also understand the objective of Raindrop is to awaken my internal healing powers and any external manipulation at the time of the raindrop session interferes with that objective. At the completion of a Raindrop Technique session I will have been lifted to a delicate state of balance and receptivity to spiritual healing energies.

8. I understand the benefits from Raindrop may not all be apparent immediately following the session. Adjustments can continue throughout the week following. Potential benefits from Raindrop cannot be predicted.

9. I understand my identity and any information about me, whether I share it with Rev. Nancy Gouch or she discovers it on her own, will be held in the strictest confidence, except when released by me or specifically required by law. I have the right to waive this confidentiality agreement in whole or part at any time.

10. I understand all charges for services by Rev. Nancy Gouch are payable by cash, check or credit card at the time services are delivered.

I have read and understand this form. I agree to pay Rev. Nancy Gouch for teaching me how to accept Divine healing using the spiritual and natural healing techniques and modalities listed in this form.

 

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