Yelena Dent – Life Coach and Magdalena Energy Practitioner
Company name – Yelena Dent LLC
Yelena Dent LLC Services
Disclosure Statement and Agreement
Welcome! This document contains important information about my professional services and business policies. Please read it carefully and note any questions you might have. If you decide to use my services and sign this document, it will represent an agreement between us.
What are Yelena Dent services?
I am a Life Coach and Energetic Healing practitioner.
Energy healing is an approach that involves balancing and restoring your body’s natural energies for the purposes of increasing your vitality, and strengthening and optimizing your health.
Enhancing Your Body’s Energies: You may have heard about subtle energy through terms such as “life force,” “chi,” “meridians,” “chakras,” “biofields,” or “auras.” In many healing traditions, life force—the animating power whose presence defines life and whose absence defines death—is understood as a form of subtle energy. People in Eastern cultures in particular, studied such energies for millennia and have successfully applied their understanding for enhancing both physical and emotional health. Systems designed to influence the body’s subtle energies include yoga, Reiki, acupuncture, acupressure, tai chi, therapeutic touch, and energy medicine, to name a few.
During the services Yelena Dent may use devices or machinery equipment such as Healy micro current device or NXI biofeedback machine. Do not use microcurrent stimulation if you:
- have a pacemaker or an implanted defibrillator, or have any metallic foreign objects in the area of application;
have an open wound or bleeding, a sensory disorder, or have had radiation therapy near the site of the electrodes;
have a fever, new scar tissue, a history of uncontrolled seizures, epilepsy;
are or may be pregnant
What are the limitations of my coaching and energetic healing practice?
Being a Life Coach and Energy Healing Practitioner does not mean that I am practicing medicine.
Energy healing is a term used by many training programs that teach people how to assess and correct for energy imbalances in the body. Energy healing is not a substitute for the diagnosis and/or treatment of medical or mental health conditions by a licensed health-care professional. If you have a disorder that has been diagnosed by a licensed medical or mental health professional or a condition that should be evaluated by a licensed health professional, my services should be used only in conjunction with you obtaining that care. I do not diagnose or treat medical or mental health disorders, nor am I trained or licensed to do so. Energy healing attempts to optimize the body’s overall health and vitality, but it is not to be used instead of appropriate care from a licensed professional.
Energy healing protocols bring disturbed energies back to a state of balance and harmony. These corrections will generally consist of my placing my hands about the chakras or organs of the body and on either side of your head or holding your head.
While the methods I use are gentle and considered noninvasive, it is possible that physical or emotional aftereffects may occur after your energies have been stimulated and adjusted. If any procedure is disquieting or leads to discomfort, please tell me at once. I will instantly stop if you request me to do so.
My Background and Training
The holistic practice of energy healing activates and stimulates the body’s energy to inherently heal itself. Studied for thousands of years, energy healing is based on scientific principles and is used in many cultures to shift, not only the physicality but the energetic systems of the body (Chakras and Subtle Bodies).
Empowered by my own life experiences and my decades of study, I am passionate about bringing permanent change to my client's lives. Working with men and women through a variety of coaching and healing practices, I educate, guide, and inspire transformation.
My teaching practices motivate action, enabling self-awareness and focus that result in altering destructive patterns and habits. Addressing the laws of vibration, I support the empowerment of my clients. We amplify their love and energy, regaining purpose, focus, and commitment. By bringing deeply rooted emotional, mental, and physical patterns to the surface, I move my clients beyond barriers to experience their own, powerful potential and healing.
Dedicated to the study and practice of energy psychology, I am committed to the benefits of merging eastern and western knowledge and traditions, with the latest scientific studies and healthy psychology. Skilled in a variety of different healing modalities, I am certified in Magdalena Energy healing and leverage the latest technologies, such as the Healy device to aide in my transformational work.
🔷 Find purpose and potential
🔷 Address limiting beliefs through quantum healing
🔷 Transform negativity and limitations
🔷 Eliminate destructive habits
🔷 Support and clear the physicality and energetic systems | Chakra | Subtle Bodies
🔷 Awakening love and compassion for themselves and others
🔷 Healy device representative
Through consistent work, you can build the momentum toward quantum awakening to achieve your own, powerful healing.
I generally schedule one appointment of 60 minutes durations per week, at a time we agree upon. Sessions may also, by prior agreement, be longer, shorter, more frequent, or less frequent.
I keep brief records on each session, primarily noting the date of the session, the interventions/protocols used, and the progress or obstacles observed as they relate to your goals in working with me. You are welcome to request, in writing, that I make available to other healthcare providers a copy of your file/record. I maintain your records in a secure location that cannot be accessed by anyone else. I will maintain your records for at least seven years after our last contact, after which time I may securely dispose of them.
With the exception of special situations described in the numbered list that follows in the paragraphs below, you have the absolute right to the confidentiality of the services I provide. I cannot and will not tell anyone else what you have told me, or even that you are having Life Coaching and/or Energy Healing Sessions with me without your prior written permission.
Under the provisions of the Health Care Information Act of 1992, I may under certain circumstances legally speak to another healthcare provider or a member of your family about you without your prior consent, but I will not do so unless the situation is an emergency. I will always act so as to protect your privacy to the best of my ability. You may direct me to share information with whomever you choose, and you can change your mind and revoke that permission at any time. You may request anyone you wish to attend a session with you.
You are also protected under the provisions of the Federal Health Insurance Portability and Accountability Act (HIPAA). This law ensures the confidentiality of all electronic transmission of information about you. Whenever I transmit information about you electronically, it will be done with special safeguards such as a secure server to ensure confidentiality. If you elect to communicate with me by email at some point in our work together, please be aware that email is not completely confidential. All emails are retained in the logs of your/my Internet service providers. Although under normal circumstances no one looks at these logs, they are, in theory, available to be read by the system administrators of the Internet service provider. As part of your record, I will keep any email I receive from you, and any responses that I send to you.
The following are exceptions to your right to confidentiality:
There are some situations in which I am legally obligated to take action to protect others from harm, even if I have to reveal some information about a client’s treatment. For example, if I believe that a child, an elderly person, or a disabled person is being abused, I must file a report with the appropriate state or local agency.
If I believe that a client is threatening serious bodily harm to another, I am required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the client.
If I believe that you are in an imminent danger of harming yourself, I may legally break confidentiality and contact the police, a local crisis team, or a family member or other intimates.
If you tell me of the behavior of another named health or mental healthcare provider that suggests this person has either (1) engaged in sexual contact with a patient, including yourself, or (2) is impaired from practice in some manner due to cognitive, emotional, behavioral, or health problems, then the law requires me [this particularly varies by state] to report this to the practitioner’s state licensing board. I would inform you before taking this step. If you are my client and are also a healthcare provider, however, your confidentiality remains protected under the law from this kind of reporting.
In certain legal proceedings, particularly those involving child custody or those in which your emotional condition or treatment is an important issue, a judge may order my testimony. Confidentiality is not protected when a judge makes such an order or in certain other legal procedures. Consult with an attorney if you are involved in a legal situation in which such confidentialities may be at issue.
If am asked to provide services to your spouse, partner, or another member of your family, we will in advance establish the limits of confidentiality. It generally confines a practitioner’s effectiveness when required to keep secrets, so my policy in most circumstances is that what you say and what we do can be shared with other family members I am working with. If this is what we establish, do not tell me anything you wish kept secret from other intimates who are receiving sessions from me. If confidential information is a concern, it may be better for each family member to work with a different practitioner.
I may occasionally find it helpful to consult other professionals about a client. During a consultation, I make every effort to avoid revealing the identity of the client. The consultant is also bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together.
Although this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, please discuss with me any questions or concerns you may have. I will be happy to explore these issues with you, but formal legal advice may be needed from an attorney because the laws governing confidentiality can be quite complex.
If you are under eighteen years of age, please be aware that the law may provide your parents or legal guardians the right to examine my records of our work together. It is my policy to request a written agreement from parents to waive their right to access your records. If they agree, I will provide them only with general information about our work together unless I feel there is a high risk that you will seriously harm yourself or someone else. In this case, I will notify them of my concern. Before giving them any information, I will discuss the matter with you, if possible, and do my best to handle any objections you may have about what I am planning to discuss.
My fee for a 60 minutes length individual coaching session is $100, couple coaching session is $177, Energy Healing session is $144. If we decide to meet for a longer session or a shorter session, I will bill you prorated on this hourly fee. In addition to scheduled appointments, I also prorate the $144 fee per hour for other professional services you may request. Other services might include emergency telephone conversations lasting longer than ten minutes, listening to lengthy voice mail messages, reading and responding to emails other than for routine business, attending meetings with other professionals you have authorized, and preparing requested records or service/session summaries. If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge $144 per hour for preparation and attendance at any legal proceeding.
Billing and Payments
You will be expected to pay for each session at the time when it is scheduled unless we agree otherwise. Payment schedules for other professional services will be agreed to when they are requested.
Once an appointment is scheduled, you will be expected to pay for it unless you provide twenty-four hours’ advance notice of cancellation. If you are late, we will still end on time and not run over into the next person’s session. If you miss a session without cancelling, or cancel with less than twenty-four hours’ notice, you must pay for that session by the time of our next meeting unless we both agree that you were unable to attend due to circumstances beyond your control. In circumstances of unusual financial hardship, I may be willing to negotiate a payment installment plan.
If that is done and your account has not been paid for more than sixty days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, those costs will be included in the claim. In most collection situations, the only information released is the client’s name, contact information, dates and type of services provided, and the amount due.
I am often with a client or otherwise not immediately available by telephone. When I am unavailable, you will reach my voice mail. I monitor it frequently and will make every effort to return your call on the same day you make it, the exception being weekends and holidays. If it will be difficult to reach you, please inform me of some times when you will be available. If you are unable to reach me and feel that you can’t wait for me to return your call, contact your family physician or, if you are experiencing a medical emergency, call 911 or go to an urgent care medical facility or to the emergency room of a nearby hospital.
Other Aspects of Our Relationship
I Welcome Your Questions: You have the right to ask me questions about anything that happens in our work together. You can ask me about my training for working with your concerns and can request that I refer you to someone else if you decide I’m not the right coach or practitioner for you. You are free to terminate our work together at any time.
Contacts outside Our Work Together: I never engage in sexual intimacies with clients or former clients and generally avoid social and business relationships. Beyond the legal and ethical considerations, our work together will be most effective when kept free from possible outside entanglements.
Legal Proceedings: If you are involved in legal proceedings based on your having been traumatized, please understand that the goals of our work together may involve healing the physical and emotional aftermath of the trauma, and this could adversely affect your ability to provide legal testimony that carries the same impact as it would prior to treatment.
Terminating Treatment: Normally, you will be the one who decides when our work together will end, but there are three exceptions to this. If I determine that I am unable, for any reason, to provide you with the services you are requesting at a high professional standard, I will inform you of this decision and refer you to another practitioner who may better meet your needs. Second, if you verbally or physically threaten or harass my office, my family, or me I reserve the right to terminate you from my services immediately and unilaterally. Third, I reserve the right to refuse or terminate a session if you or anyone in the session is suspected of being under the influence of a mood-altering substance. You will be responsible and charged for full payment of the normal fee for service.
Vacations: I am away from the office several times each year for vacations or to attend professional meetings. I will make every effort to tell you well in advance of any anticipated lengthy absences and to discuss other options for continuing to work toward your goals during my absence.
If you are unhappy with the way our work together is proceeding, I hope you will talk about it with me so that I can respond directly to your concerns. I will take such concerns seriously and meet them with care and respect. You are also free to discuss any complaints about me with anyone you wish. You do not have any responsibility to maintain confidentiality about what I say or do. You are the person who has the right to decide what you want kept confidential.
Your signature below indicates that you have read the information in this document, understand it fully, have discussed any questions or matters of concern with me and/or others, and agree to abide by its terms during our professional relationship.
Printed Client Name: Date:
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