Client Liability Waiver & Informed Consent Agreement

Pelvic Luminary LLC, doing business as MindBodyMir

This agreement is between the undersigned client ("Client") and Pelvic Luminary LLC (doing business as MindBodyMir, “Practitioner”) for participation in individual or group sessions involving Breathwork, intuitive guidance, somatic and energetic healing, Pain Reprocessing Therapy, Emotional Awareness and Expression Therapy, Holistic Pelvic Care and related services.

Nature of Services
These sessions are somatic, emotional, and energetic in nature. They may involve breathwork, intuitive guidance, pelvic-womb presence, ritual, and reflection. They are not clinical treatment, and do not include physical therapy, mental health care, diagnosis, or medical advice.

Breathwork may bring up a range of physical or emotional responses—such as tingling, tension, temperature shifts, or emotional release. These are natural parts of the body's processing and vary for each person.

Although the Practitioner has prior training as a physical therapist, she is not currently licensed and is not acting in a clinical or medical role.

No Medical or Therapeutic Relationship
These sessions do not constitute a doctor-patient or therapist-client relationship. The Practitioner is not diagnosing or treating any medical or psychological condition. Clients are encouraged to consult a licensed provider for any health concerns.

Personal Responsibility
Participation is voluntary. Clients take full responsibility for their physical, emotional, mental, and energetic well-being during and after sessions. No specific outcomes are guaranteed.

Confidentiality
Information shared in private sessions is kept confidential unless disclosure is required by law. In group sessions, confidentiality cannot be guaranteed and clients are responsible for what they choose to share.

WhatsApp Support (Package Clients Only)
Packages include light WhatsApp support between sessions for integration check-ins or focused questions that arise in your process. This space can hold depth, but it is not meant for extended back-and-forth conversations or real-time support. Messages will be responded to within 1–2 business days, Monday–Friday.

Session Packages
Packages are non-transferable and must be used within the timeframe specified at purchase (e.g., 3 months or 6 months).

Cancellations, Lateness, & Refunds
• Clients may reschedule with 24 hours' notice
• One emergency cancellation is allowed
• Arrivals more than 15 minutes late will result in a forfeited session
• All sessions and packages are non-refundable

Release of Liability
Clients waive and release any and all claims against the Practitioner for injuries, discomfort, or perceived negative outcomes that may arise through participation. Clients agree to indemnify and hold the Practitioner harmless from any legal claims.

Acknowledgment
By submitting this form or booking a session, the Client affirms they have read and understood this agreement, and voluntarily agree to the terms outlined.