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Look Within Holistic Coaching Logo on Client Consent &

Client Consent & Liability Release Form

Look Within Holistic Coaching LLC


Client Consent, Disclaimer, and Release of Liability


(Heather Headley, RN, BSN — Reiki Master, Intuitive Coach, Founder)


Please read carefully before signing.


Nature of Services


I understand that the services provided by Look Within Holistic Coaching LLC (including but not limited to Reiki, intuitive guidance, energy work, holistic coaching, meditation, and related offerings) are intended for personal growth, relaxation, and spiritual support.


I acknowledge that these services are not medical, psychological, legal, or financial advice, nor are they a substitute for licensed professional care.


No Guarantees


I understand that all intuitive, spiritual, and energetic guidance is based on the practitioner’s personal insights and interpretations.


It is my responsibility to interpret and apply any information in a way that feels appropriate for my life. No outcomes are promised or guaranteed.


Medical / Professional Disclaimer


I acknowledge that Heather Headley, RN, BSN, is not acting in the capacity of a medical doctor, psychologist, psychiatrist, financial advisor, or attorney during these services, nor is she acting in a medical capacity as a Registered Nurse (RN).


I understand that all services provided are for relaxation, personal growth, and spiritual support only.


I will not disregard, delay, or discontinue medical or psychological treatment based on anything discussed or shared during a session.

I am solely responsible for seeking appropriate professional care for any physical, mental, emotional, or financial concerns.


I also understand it is my responsibility to inform the practitioner of any health conditions, medical devices, injuries, sensitivities, or accommodations needed for my safety and comfort prior to any session.


Reiki-Specific Acknowledgment


I understand that Reiki is a gentle, non-invasive energy technique used for stress reduction and relaxation. Reiki practitioners do not diagnose conditions, prescribe, or perform medical treatment.


Reiki does not take the place of medical or psychological care, though it may complement existing treatments.


I acknowledge that the body has the natural ability to heal itself and that deep relaxation can support this process. I also understand that long-term imbalances may require multiple sessions to facilitate the level of relaxation needed for the body to support its own healing.


Assumption of Responsibility


I agree that it is my personal decision to receive these services and that I am solely responsible for my own choices, interpretations, and actions during or after the session.


I will not hold Heather Headley or Look Within Holistic Coaching LLC liable for any effects that may arise if I have not fully disclosed my health history or if a service is later found to be contraindicated by my medical professional.


Use of Artificial Intelligence (AI) Tools


I acknowledge and agree that Look Within Holistic Coaching LLC may use secure, third-party artificial intelligence (AI) software for the limited purpose of assisting with note-taking, documentation, and preparation of session summaries.


  • The AI software is used as an administrative and organizational tool only and does not provide medical, psychological, legal, or financial advice.

  • Any information processed by AI tools is treated with the same confidentiality standards as all other client records.

  • Identifying details may be anonymized or minimized to protect privacy.

  • Session notes and summaries remain the property of Look Within Holistic Coaching LLC and are maintained in accordance with applicable privacy laws.

  • Clients may request at any time that AI not be used in relation to their sessions.


By signing this consent, I acknowledge that I understand the use of AI software is solely for documentation support and does not replace the personal services or professional judgment of my practitioner.


Communication, Email & Text Messaging Consent

By signing this agreement, I consent to receive communication from Look Within Holistic Coaching LLC, including but not limited to:


  • Appointment confirmations and reminders

  • Session summaries and follow-up information

  • Scheduling coordination and general check-ins related to services I have scheduled or received

  • Occasional newsletters, blog updates, and promotional emails about services, events, or new offerings


I also consent to receive text (SMS) messages from Look Within Holistic Coaching LLC and its authorized messaging platforms (including Omnisend and Wix) for the purposes of:


  • Appointment confirmations, reminders, and schedule changes

  • Session information, follow-ups, and ongoing client support check-ins

  • Updates, announcements, and—if separately opted in—marketing communications


I understand that message and data rates may apply and that message frequency may vary. I may unsubscribe or opt out of marketing communications at any time by replying STOP to a text message, clicking “unsubscribe” in an email, or contacting heather@look-within.com directly. Transactional communications (such as scheduling coordination, service updates, or follow-ups related to active sessions) are considered a necessary part of service delivery and are not treated as marketing messages.


Testimonials, Feedback & Marketing Use


I consent to allow Look Within Holistic Coaching LLC to use any positive feedback, testimonials, or comments that I voluntarily provide through any medium—including text message, phone call, email, written communication, online reviews, or verbal comments—for marketing and promotional purposes.


This may include—but is not limited to—posting on the company’s website, social media platforms, newsletters, printed materials, advertisements, and other digital marketing channels.

My name and identifying details may be abbreviated or anonymized if preferred upon request.


Release of Liability


I hereby release and hold harmless Heather Headley and Look Within Holistic Coaching LLC from any and all claims, liability, damages, or expenses arising from my participation in these services.


I understand that I am voluntarily choosing to participate and assume full responsibility for my experience and interpretation of the information provided.


Consent to Services


By signing below, I confirm that I have read, understood, and agreed to this disclaimer in full.


My signature constitutes consent to:

  • Receive services from Heather Headley and Look Within Holistic Coaching LLC

  • Allow the limited use of AI for administrative documentation

  • Receive communication via phone, email, and text message

  • Permit the potential use of my positive feedback or testimonials for marketing purposes

  • Release the practitioner and business from all liability


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