Monica Nagler Family Constellation Facilitator

Family Constellation Participant Release Form

I am fully stepping into this Family Constellation with full acceptance of my own self-healing abilities and responsibilities for my own healing.

I fully understand the session may bring up issues of a highly personal nature and may cause me to experience some unexpected and/or physical responses. Further, I understand that I may experience some emotional, physical or spiritual distress that may cause unpleasant symptoms. I agree to assume responsibility/risk for any such manifestation encountered on my part in this session or future sessions.

I do not currently suffer from any major mental or physical impairment and have not been diagnosed in the past with any disorder, condition, or injury, either physical or mental, that would make it inadvisable for me to assume such risks. I am not currently in a crisis or suffering from acute trauma or distress.

I acknowledge that this session or future sessions are not designed as a substitute for therapy with a psychiatrist, psychotherapist or other mental health care professional or as a substitute for any other professional consultation. I understand that Family Constellations are designed as an educational experience only.

By signing this document, I willingly agree to hold harmless and release from all liability the facilitator, Monica Ann Nagler, and Monica Nagler Spaces. I consent to participate in this Family Constellation session and/or future sessions.

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Name:_____________________________________________Date:________________________________Signature:_________________

Email_____________________

Monica@MonicaNaglerSpaces.com www.MonicaNaglerSpaces.com