Legal Disclosures

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What you understand and agree to when booking an appointment


Barbie Moreno

www.BarbieMoreno.com

(657) 221-9204 

California Client Information Form, Acknowledgement, & Consent to Receive Treatment (in accordance with CA Senate Bill SB-577)

What is Reiki?

Reiki is a form of complementary health care practices, which have been found to enhance the body’s ability to heal itself.

What Reiki is not.

Your practitioner is not a licensed physician, and Reiki does not require licensing by the state. It is meant to be a complement to “healing arts services licensed by the state”; ie:, it is a complement to traditional Western medicine provided by doctors, nurses, and other licensed medical professionals.

Theory of Treatment

Stress, trauma and illness restrict the natural flow of ki (chi) or “life force energy” through the body. By restoring the flow of life force energy through the body, Reiki rejuvenates the body’s ability to relax and, therefore, supports the body’s ability to heal itself. 

Although one session may be adequate, long-term imbalances in the body sometimes require multiple treatments in order to allow the body to reach the level of relaxation necessary to bring the system back into balance. Improvement often requires commitment on the client’s part (e.g., willingness to make lifestyle changes) in order to fully benefit from Reiki treatment(s).

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What is Hypnotherapy?

Hypnotherapy uses the power of positive suggestion to bring about subconscious change to our thoughts, feeling, and behavior.

The definition of hypnosis given by the U.S. government is “The bypass of the critical factor of the conscious mind and the establishment of acceptable selective thinking.”.

Licensing

There are no state licensing for either Reiki, counseling, or hypnosis. The services do not include the practice of medicine or psychology or any other licensed healing art, since I am not a licensed physician. 

What is a Psychic, Medium, and Intuitive Life Path Coach?

The definitions vary from site to site and person to person. I suggest researching the definitions for more details and clarity. 

I am making no claims or guarantees with any of my services.

California State Senate Bill SB 577

California Senate Bill SB 577, which was signed by the Governor in September 2002, has profound implications for the practice of alternative forms of healthcare in California. SB 577 enables alternative and complementary health care practitioners (including, but not limited to, Reiki) to provide and advertise legally. They must also, however, comply with certain requirements specific within the bill.

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What does Senate Bill SB 577 mean for you, the patient?

SB 577 provides you with access to alternative and complementary health care practitioners. You must be given information about the nature of treatment and practitioner’s qualifications. Feel free to ask a practitioner any question you might have about your treatment. Check to see if your practitioner has been certified by a professional membership society. In addition, tell your doctor about any alternative treatment you are pursuing. You can also request that your licensed and unlicensed health care providers communicate with each other and work collaboratively to meet your health care needs. 

How SB 577 helps protect you

SB 577 requires unlicensed alternative health care practitioners to follow certain guidelines and restrictions. Here are the things that unlicensed alternative practitioners are NOT allowed to do:

  1. Perform any form of surgery or any procedure that punctures your skin or harmfully invades your body.
  2. Use X-Ray radiation
  3. Prescribe prescription drugs, or recommend that you discontinue drugs that were prescribed by a licensed physician.
  4. Set fractures
  5. Treat wounds with electrotherapy
  6. Put you at risk of great bodily harm, serious physical or mental illness, or death. 
  7. Imply in any way that they are licensed physicians.

In addition, an unlicensed alternative health care practitioner must do the following things:

  1. Provide you with a statement, written in plain language, that includes the following information:
    1. That he or she is not a licensed physician and that his or her services are not licensed by the state.
    2. A brief clear description of the kind of services he or she provides and the reasoning behind it.
    3. A description of his or her education, training, and experience.

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  1. Ask you to sign an acknowledgement that you have received a Client Information and Consent to Receive Treatment Form, and provide you with a copy of it.
  2. They must keep a copy of your signed acknowledgement for three years.

Nature of Services Provided

During a Reiki session, the client is asked to lie down. He/She remains fully clothed during the treatment session. The majority of the session will involve the practitioner holding his/her hands about 2-3 inches above the client’s body. If guided to do so, the practitioner will ask permission to place his/her hands on your body but ONLY in a manner acceptable to you and within the legal limits of his/her practice as a Reiki Practitioner.

Once the session begins, the practitioner allows the life force energy to flow through his/her hands, which may be experienced by the client as heat, coolness, vibrating, tingling, a light pressure, a slight pulling sensation, or nothing at all. The Practitioner may also use other hands-off techniques, such as sweeping the body of unneeded energy or using vocal tones to break up energy blocks. The practitioner is simply a conduit or channel of the life force energy. It is believed that the energy is guided by God/Source/Spirit for the physical, mental, emotional, and/or spiritual well-being of the client. Therefore, a specific outcome cannot be guaranteed by the Reiki Practitioner. 

During a hypnotherapy, the practitioner will be start by using an induction, then go into a deepening technique, finally onto the suggestions and then bring you back into the current time and place of your conscious mind.

Barbie Moreno’s Qualifications

Barbie Moreno is a certified Reiki Master and Karuna Reiki practitioner. Barbie Moreno is also a certified hypnotherapist. Barbie is enrolled in psychic development courses and attends classes on a weekly basis to help her increase her metaphysical skills and knowledge. Additionally, Barbie is an ordained minister.

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Acknowledgement & Consent to Receive Services

In order to use Ageless Beauty Healings’ (Barbie Moreno) services, California state law requires that you acknowledge receipt of the information provided in this form. You are required to sign this form in order to receive services. You will be provided with a copy for signature at your first visit and a scan of the original will be maintained on file by Ageless Beauty Healings for three years. 

  1. I have read and understand the above guidelines and disclosures about the treatment and techniques offered by Barbie Moreno.
  2. I have discussed any concerns with Barbie regarding the nature of the treatment she will be providing.
  3. If I experience any discomfort during the session(s), I agree to immediately inform Barbie. 
  4. I understand that Barbie is not a licensed physician and that the alternative services that she will be providing me are not licensed by the State of California.
  5. I understand it is my responsibility to maintain a relationship for myself and/or my child with a medical doctor.
  6. I understand that Reiki is not a substitute for medical treatment or medications. I am aware that Barbie Moreno does not diagnose illness or disease nor does she prescribe medications or recommend supplements. I understand that any suggestions that are provided to me should not be taken as a diagnosis or recommendation against the advice of a licensed physician or mental health professional.
  7. I have consented to use of the services offered by Barbie Moreno, and I agree to be personally responsible for her fees in connection with the services provided. 
  8. If requested, I have been provided with a copy of California Senate Bill SB-577.

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Client Acknowledgement

I have read and understand the above disclosure regarding the Reiki treatments I will be receiving from Barbie Moreno. I have been provided a copy of the above document, in accordance with California State Law SB-577. 

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Print name of the client

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Print name of person signing (if different) Relationship to Client

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Signature Date

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