Wavier

Please read this agreement it its entirety then sign the agreement at the bottom of the page. All Relief Room™ participants must have a waiver signed prior to participation.

PARTICIPANT WAIVER, INFORMED CONSENT & RELEASE OF LIABILITY

1. Voluntary Participation & Assumption of Risk

I understand that my participation in somatic, breathwork, sound healing, yoga, and related wellness sessions (“Practicum”) offered by Jessica Hooley (“Jessa”) and Natalie Kimball (“Facilitators”) is entirely voluntary.

I knowingly and freely assume all risks—physical, emotional, and psychological—associated with participation. I understand that any actions or decisions I take during or after the Practicum are my sole responsibility. Any injury, loss, or damage to my person or property arising from participation is not the responsibility or liability of the Facilitators.

2. Nature of Services & Medical Disclaimer

I understand that the services provided are holistic wellness and educational experiences, not medical, psychiatric, psychological, or mental health treatment.

I acknowledge and agree that:

I am not receiving medical care from Jessa Hooley or Natalie Kimball
These services do not constitute medical diagnosis, treatment, or therapy
These services are not governed by medical laws or regulations, including HIPAA
No medical records are created
No medical billing is submitted
No patient-provider or clinician-patient relationship is being formed

Although Natalie Kimball is a Nurse Practitioner, she is not acting in a medical or clinical capacity during these sessions. Her participation does not involve medical assessment, diagnosis, treatment, prescribing, or clinical decision-making.

3. HIPAA & Privacy Clarity

a. HIPAA Does Not Apply

I understand that because these services are not medical or mental health services, they are not subject to the Health Insurance Portability and Accountability Act (HIPAA) or other laws governing medical privacy.

Jessica Hooley and Natalie Kimball are not acting as “covered entities” or “business associates” under HIPAA in this context.

b. Confidentiality Practices (Non-HIPAA)

While HIPAA does not apply, I understand that the Facilitators still take privacy and discretion seriously and make reasonable efforts to maintain confidentiality.

However, I acknowledge that:

Communications, session notes, or intake forms are not medical records
Information shared may not be protected under HIPAA standards
Confidentiality may be limited in cases involving safety concerns, legal requirements, or threats of harm to self or others

c. Electronic Communication & Data Handling

I understand that email, online forms, scheduling systems, text messages, and other electronic communications used in connection with these services are not HIPAA-compliant medical systems.

By participating, I consent to the use of these communication methods and understand the inherent risks of electronic data transmission.

4. Not a Substitute for Medical or Mental Health Care

I understand that Jessa Hooley is not a licensed medical provider, mental health professional, psychologist, psychiatrist, or therapist.

I further understand that the modalities offered are not substitutes for:

Medical care
Mental health treatment
Psychotherapy or counseling
Substance abuse treatment

I agree not to use these services as a replacement for care from licensed medical or mental health professionals. I acknowledge that it is my responsibility to consult with my healthcare providers regarding my suitability for participation.

5. Scope of Practice & Ethical Boundaries

I understand that the Facilitators operate strictly within the scope of their training and certifications. They do not make medical claims, promise outcomes, or attempt to treat medical or psychiatric conditions.

I acknowledge that no guarantees of results are made and that outcomes vary between individuals.

6. Emotional, Physical & Psychological Risks

I understand that the Practicum may involve emotional release, physical movement, breathwork, sound, meditation, or behavioral experimentation, which may cause temporary or lasting physical, emotional, or psychological responses.

While all reasonable efforts are made to create a safe and supportive environment, risks cannot be completely eliminated. I accept full responsibility for my participation and agree to communicate my limits, concerns, or discomfort during sessions.

7. Agreements Regarding Therapeutic Touch

I understand that some sessions may involve consensual touch. I understand that Jessa Hooley and Natalie Kimball are not licensed massage therapists and do not offer touch in a therapeutic capacity.

I acknowledge that:

I have the right to refuse or withdraw consent for touch at any time
Facilitators may also refuse to offer touch at any time
Self-touch is always offered as an alternative

NO TOUCH IS GIVEN WITH ANY SEXUAL OR THERAPEUTIC INTENT.

Any sexualized behavior or touch—including genital touch or self-touch—will result in immediate termination of services without refund.

8. Biodynamic Breathwork & Trauma Release® (If Applicable)

I understand that Biodynamic Breathwork and Trauma Release System® (BBTRS®) may include breathing, movement, sound, emotional expression, and body awareness.

I acknowledge that BBTRS®:

Does not diagnose illness or disease
Does not prescribe medications
Is not a substitute for medical or mental health care

I acknowledge that breathwork is not recommended for individuals with certain conditions (including but not limited to):

pregnancy
epilepsy
severe cardiovascular disease
untreated mental illness
severe asthma
acute injury
severe diabetes

I agree to disclose relevant conditions prior to participation and confirm I am not under the influence of drugs or alcohol.

9. Financial Responsibility & Indemnification

I agree to assume full financial responsibility for any medical care I may require as a result of participation.

I hereby release, indemnify, defend, and hold harmless Jessica Hooley, Natalie Kimball, and their agents from any and all claims arising from participation, except in cases of gross negligence or intentional misconduct where prohibited by law.

This agreement binds my heirs, estate, and legal representatives.

10. Security Recording Consent

I understand that security cameras may be in use at facilities owned or operated by Jessa Hooley and consent to being recorded for safety and security purposes. Recordings will remain confidential unless required for security or legal reasons.

11. Legal Binding Agreement & Governing Law

I understand that this document is a legally binding Release of Liability and Assumption of Risk Agreement governed by Utah law. If any provision is found unenforceable, the remaining provisions shall remain in effect.

I affirm that I have read and understood this agreement fully and voluntarily agree to its terms.

Questions regarding this agreement may be directed to: jessa@alwaysvibin.com