I understand that the role of Medina Mindshift and Michelle Medina is not to treat any health issues including physical and mental health. I am aware that they are not acting in the capacity of a Medical Doctor, Psychologist, or Therapist. I understand that any advice given by Medina Mindshift or Michelle Medina is not meant to take the place of advice by these professionals.

I understand that if I am under the care of other healthcare professionals and/or currently uses prescription medications, I should discuss any changes with my doctor, and should not discontinue any prescription medications without first consulting my doctor.

I agree that I have chosen to work with Medina Mindshift / Michelle Medina and understand that the information received is not meant to take the place of other licensed health professionals.

I acknowledge that I, the Client, take full responsibility for my life and well-being, as well as the lives and well-being of my family and children (where applicable), and all decisions made during and after the services provided. I assume the risks of the Program/Services.

I release Medina Mindshift / Michelle Medina from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which I, the Client, ever had, now has or will have in the future against the provider, arising from my past or future participation in, or otherwise with respect to, the Program/Services, unless arising from the gross negligence of Medina Mindshift / Michelle Medina.

Medina Mindshift / Michelle Medina will keep the Client’s information private, and will not share my, the Client’s, information to any third party unless compelled to by law.

I acknowledge that I am voluntarily participating in the services provided by Medina Mindshift / Michelle Medina, and agree to the following:

• I waive, release, and discharge Medina Mindshift / Michelle Medina and their employees from any and all negligence and liability for my death, disability, personal injury, property damages, property theft or claims of any nature which may hereafter accrue to me, and my estate as a direct or indirect result of my participation in their services.
• I agree to defend, indemnify, and hold harmless Medina Mindshift / Michelle Medina and their employees against any and all claims of any nature including all costs, expenses and attorneys’ fees, which in any manner result from my participation in their services.