top of page

Informed Consent

​

 

Experiences with Joanna Tholstrom guide + support deep self exploration and transformation in the physical, mental, emotional, spiritual, and energetic body through a variety of ancient and modern practices. The powerful tools and modalities used in practice with Jo create experiences felt in varied levels of consciousness. 

 

Because these experiences can bring up intense emotions and strong physical experiences, I understand that issues arising from my participation may require additional therapeutic or supportive interventions. These experiences have the potential to create both desirable and undesirable effects.

 

If you are pregnant, taking anticoagulant drugs (ex. Coumadin), have a severe bleeding disorder (hemophilia), have a heart condition, diabetes, circulatory problems, blood clots, cancer/malignancies, bone disorders (osteoporosis/Paget’s disease/multiple myeloma), any serious medical condition, metal implants or a pacemaker, please make this information known to me prior to your treatment.

 

I acknowledge that I am voluntarily participating breathwork based meditative movement and energetic experiences, with Joanna Tholstrom.

 

I understand that any coaching I experience does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association.  I understand that coaching is not a substitute for counselling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment.


I acknowledge and understand that I am responsible for all aspects of my health and well-being.  I further recognize and understand that the instructions and advice presented to me are in no way intended as substitutes for medical and/or other professional counseling.  If I have any health concerns that may interfere with my participation, I understand that I should consult my healthcare provider before beginning the meditation and movement exercises, and should inform Joanna Tholstrom.  If I experience pain or difficulty that is cause for concern during or after practicing the exercises, I understand that I should stop immediately and consult my healthcare provider before continuing on. 

I recognize, understand, and assume all risks associated with my voluntary participation, including, but not limited to, those risks that may result in personal injury and death.  In giving my informed consent to participate, I hereby release Joanna Tholstrom and Nyhavn, LLC. from any and all claims, now or in the future, that I may have as a result of my voluntary participation in the services Joanna Tholstrom.

24 hours notice policy for cancellations or changes of scheduled appointments. less than 24 hours notice will result in a charge applied at discretion of Jo, and not to exceed total session price.  

All information that you share will be held as confidential, unless there is considerable concern for your safety or the safety of another individual. 


It is your responsibility to let me know if there are any specific goals or topics you would like to discuss or explore or health conditions I should be aware of. 


Payment is due in full at the time of service for both services and products.

policy + consent

Thank you for your consent

bottom of page