Client Information, Participation Agreement & Appointment Policy Contract
Alexandra Joy Seits, Alljoys LLC, DBA Inlet Behavioral Wellness, office@alljoysco.com
If you are a psychotherapy client, please refer to your Simple Practice portal for your psychotherapy paperwork with Alljoys LLC, DBA Inlet Behavioral Wellness.
If you are a student or client for coaching, hypnotherapy, subconscious reprogramming, somatic work, yoga instruction, consultation sessions, workshops, or classes please refer to the agreement and policies below.
The goal is to provide quality individualized consulting, hypnosis, executive coaching, somatic work, and yoga in a timely manner. If you reserve time to talk with us, we want to make sure as much of that time as possible is spent on the reason why you want to have a hypnosis session or executive coaching meeting, not on administrative concerns. For that reason, we have all administrative policies listed in this document. Because we cannot predict every unique situation that comes up, there may be times when you have a question that is not covered in this document. In that event, please send an email and we will respond as quickly as we can.
Alljoys Coaching, Consulting, Somatic Work, & Hypnotherapy Services Agreement
Alexandra is trained and practices as a psychotherapist in the state of Florida; however, within the context of coaching and hypnotherapy, she is not conducting psychotherapy. If you need psychotherapy and are not located in the state of Florida where Alexandra is registered, please find a licensed provider in your area instead.
Hypnosis and Holistic/Spiritual Services Agreement
(Including, but not limited to additional services like Consent Form for Brain Stimulation or Transcranial Alternating Current Stimulation (tACS), Akashic Record Reading, Ancestor Meeting, Alpha Brain Neurostimulator, General Hypnosis Recording, Oracle Card Reading, Personalized Hypnosis Session Recording, Somatic Embodiment Alignment, Yoga)
Hypnosis and Self-hypnosis are not absolute sciences. We personally know of no case on record where an individual has been harmed by the use of these methods. We do know of many cases where people of all walks of life have benefited greatly from the use of these methods. As a general practice, it is necessary for everyone taking part in private sessions, classes, workshops and seminars with Alljoys Coaches, to agree this disclaimer:
I am of legal age, and in consideration of my acceptance as a participant in this Private Hypnotherapy (Including, but not limited to Add-ons like Akashic Record Reading, Ancestor Meeting, Consent Form for Brain Stimulation or Transcranial Alternating Current Stimulation (tACS), General Hypnosis Recording, Oracle Card Reading, Personalized Hypnosis Session Recording, Somatic Embodiment Alignment, Yoga) session, Seminar, Workshop, Class or Training, I for myself, my heirs, my executors, administrators and assignees, do hereby release and discharge Alljoys LLC, DBA Inlet Behavioral Wellness and Alexandra Joy Seits and any of her contractors, her employees, her employer, or other participants in any of the activities, from all claims of damages arising from, or growing out of my participation. I further understand that recordings may be made at any of these events, and that Alexandra Joy Seits and her organization retain the copyright to these recordings and that they not be shared beyond the intended recipient.
Coaching Agreement
This Agreement is entered into by and between: Alexandra Joy Seits, MSW, RCSWI, CHT, RYT, Alljoys LLC, Alljoys coaches and Client whereby Coach agrees to provide Coaching Services for Client focusing on the following topics/results/outcomes/goals attached to this Agreement.
Description of Coaching: Coaching is partnership (defined as an alliance, not a legal business partnership) between the Coach and the Client in a thought-provoking and creative process that inspires the client to maximize personal and professional potential. It is designed to facilitate the creation/development of personal, professional or business goals and to develop and carry out a strategy/plan for achieving those goals.
1) Coach-Client Relationship
A. Coach agrees to maintain the ethics and standards of behavior.
B. Client is solely responsible for creating and implementing his/her own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the coaching relationship and his/her coaching calls and interactions with the Coach. As such, the Client agrees that the Coach is not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by the Coach. The Client understands coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease. The Client understands that even though Alexandra Joy Seits is trained as a therapist, she, nor other Alljoys coaches, are not providing therapy services in her coaching.
C. Client further acknowledges that he/she may terminate or discontinue the coaching relationship at any time.
D. Client acknowledges that coaching is a comprehensive process that may involve different areas of his or her life, including work, finances, health, relationships, education and recreation. The Client agrees that deciding how to handle these issues, incorporate coaching principles into those areas and implementing choices is exclusively the Client’s responsibility.
E. Client acknowledges that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association and that coaching is not to be used as a substitute for counseling, psychotherapy, psychoanalysis, mental health care, substance abuse treatment, or other professional advice by legal, medical or other qualified professionals and that it is the Client’s exclusive responsibility to seek such independent professional guidance as needed. If Client is currently under the care of a mental health professional, it is recommended that the Client promptly inform the mental health care provider of the nature and extent of the coaching relationship agreed upon by the Client and the Coach.
F. The Client understands that in order to enhance the coaching relationship, the Client agrees to communicate honestly, be open to feedback and assistance and to create the time and energy to participate fully in the program.
2) Services The parties agree to engage in a Coaching Program through in-person, internet, or telephone meetings. Coach will be available to Client by email and voicemail in between scheduled meetings as defined by the Coach. Coach will return phone calls and text messages on her office line as soon as possible, usually within 48 hours. Coach may also be available for additional time, per Client’s request on a prorated basis rate (for example, reviewing documents, reading or writing reports, engaging in other Client related services outside of coaching hours).
3) Schedule and Fees This coaching agreement is valid as of the time payment, sessions, packages, and work has started together. The fee or a package price per month based on (frequency of meetings such as number of meetings per week, month, recordings, level of support, etc.) is as indicated on the payment page. The session calls/meetings shall be 50 minutes. The rates are subject to change. The refund policy in effect for the term of this Agreement is as follows: No refunds are available.
4) Procedure The time of the coaching meetings and/or location will be determined by Coach and Client based on a mutually agreed upon time. The Client will initiate all scheduled calls, sessions, and will call the Coach or show up at the designated video session sent to the client for all scheduled meetings through the designated link. If the Coach will be at any other number for a scheduled call, Client will be notified prior to the scheduled appointment time.
5) Confidentiality This coaching relationship, as well as all information (documented or verbal) that the Client shares with the Coach as part of this relationship, is bound by the principles of confidentiality. However, please be aware that the Coach/Client relationship is not considered a legally confidential relationship (like the medical and legal professions) and thus communications are not subject to the protection of any legally recognized privilege. The Coach agrees not to disclose any information pertaining to the Client without the Client’s written consent. The Coach will not disclose the Client’s name as a reference without the Client’s consent. Confidential information does not include information that: (a) was in the Coach’s possession prior to its being furnished by the Client; (b) is generally known to the public or in the Client’s industry; (c) is obtained by the Coach from a third party, without breach of any obligation to the Client; (d) is independently developed by the Coach without use of or reference to the Client’s confidential information; or (e) the Coach is required by statute, lawfully issued subpoena, or by court order to disclose; (f) is disclosed to the Coach and as a result of such disclosure the Coach reasonably believes there to be an imminent or likely risk of danger or harm to the Client or others; and (g) involves illegal activity. The Client also acknowledges his or her continuing obligation to raise any confidentiality questions or concerns with the Coach in a timely manner.
6) Release of Information (Optional, based upon specific situation) The Coach engages in training and continuing education pursuing and/or maintaining credentials. That process requires the names and contact information of all Clients for possible verification by credentialing organizations. By signing this agreement, you agree to have only your name, contact information and start and end dates of coaching shared with credentialing organizations, staff members and/or other parties involved in this process for the sole and necessary purpose of verifying the coaching relationship; no personal notes will be shared. According to the ethics of our profession, topics may be anonymously and hypothetically shared.
7) Severability If any provision of this Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If the Court finds that any provision of this Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited.
8) Waiver The failure of either party to enforce any provision of this Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this Agreement.
9) Applicable Law This Agreement shall be governed and construed in accordance with the laws of the State of New Jersey, without giving effect to any conflicts of laws provisions.
10) Binding Effect This Agreement shall be binding upon the parties hereto and their respective successors and permissible assigns.
Cancellation of an Appointment
No-shows and late cancellations interrupt the hypnotherapy and executive coaching process by stretching out appointment times and increasing the likelihood that we will forget what we wanted to discuss or we may have to spend extra time catching up and repeating work that we may have already done before. No-shows and late cancellations also prevent other clients in need from being able to schedule appointments during that time frame. In an effort to respect everyone’s hypnotherapy and coaching process and to be fair to all clients, I have a no-show/late cancellation policy.
Late Cancellations: A cancellation is considered to be late when the appointment is canceled without a 48 hour advance notice. No-shows: A no-show is when a person misses an appointment without any advance notice. This means that they do not arrive at a scheduled in-person appointment, they are not present online/on video for a scheduled video session, or they do not answer the phone for a scheduled phone session. If a late cancellation or a no-show occurs, a fee is assessed and no future appointments can be scheduled until this fee is paid. Appointments are in high demand, and your early cancellation will allow another client access to timely hypnotherapy or coaching.
For online video and phone sessions only: Sometimes it is possible to move an appointment to another time within the same day/week. This possibility cannot be guaranteed, but if we are able to move an appointment up or back within the day or the week, then the fee can be waived. Because physical space is reserved and often paid for with a third party in advance, I cannot waive the fee for rescheduled in-person sessions.
How to Cancel Your Appointment
If you are unable to be present for an appointment, you should cancel using Acuity. If need be you can email, please use office@alljoysco.com.
How Appointments Are Conducted
For in-person sessions: I have space available and I am also available for in-studio, in-home, or in-community sessions for all private pay clients. It is expected that all parties, myself and the client, will be present at the pre-arranged address at the time the appointment is scheduled.
For phone sessions: I can call or the client can call at the scheduled time. I will often send a text to the client a few minutes before the session is scheduled to begin to ensure that the client is able to talk at the moment I call. My text will be similar to this: “Hi, this is Alexandra, is this a good time to call?” Most times, clients text back “yes”, and then I call them. Once in a while though, I get a text back, “can you give me 5 minutes” – and yes, absolutely I can give someone a few minutes. I understand that we all have busy lives and sometimes things pop up at the last minute. Waiting a little bit is never a problem for me.
For video sessions: This process is very similar to the phone process. I use a few different platforms for online video hypnotherapy, and which platform is used is discussed at the time we schedule the session. At the scheduled time of the session, both of us are expected to be present and available on the platform of our choosing. I ask that all clients consider their comfort level and privacy needs in choosing where they want to be for their session. Many clients will be in their homes; some clients have found private spaces at their jobs as well. I can conduct an executive coaching session with a client who is in a public setting, such as a coffee shop, but please remember that as people walk around you, they may overhear your conversation, even if you are using headphones and speaking quietly. I conduct my sessions in a private space where I can ensure that I am alone and that there will be silence and no distractions, but please be aware that when you move into a public setting, you lose the ability to control the outside sounds and distractions you pick up during your session. That said, I do understand that clients have very different needs, comfort levels and access to the internet, so to that end, I am supportive of anyone who does have to use a public space in order to access executive coaching. I can be liable and responsible for ensuring privacy and as few distractions as possible on my end, but I cannot be liable or responsible for privacy and controlling distractions on your end. For hypnosis sessions, it is important that you are in a private, comfortable, and quiet space for the nature of the work.
Services, Communication, Writing, Reports, Phone Calls, etc.
The parties agree to engage in a Hypnosis and Executive Coaching program through in-person, internet, telephone sessions and recordings.
There is not the availability for support over email, phone, nor text between sessions and the other offerings in Alljoys packages have to be purchased separately. Alljoys and Alexandra can only email for scheduling purposes and administrative resources, not content related to personal issues, which is why we offer the exclusive programs with Voxer support for end-to-end encryption. Hypnotherapist/ Executive Coach will be available to Client by email and voicemail in between scheduled meetings as defined by the Hypnotherapist/Executive Coach if Client has an urgent situation, Client can call or leave a voicemail, to schedule an additional session. However, client should not put any confidential nor personal information in emails. Hypnotherapist/Executive Coach will check voicemail and email once per day on weekdays unless otherwise noted. Due to the nature of the communication and confidentiality, Hypnotherapist/Executive Coach cannot be available over email or text messages other than for scheduling needs. If it is urgent, Hypnotherapist/Executive Coach and Client may try to schedule a brief call in or if needed, an additional session, both of which additional fees apply. If this is a mental health emergency, Client should get the necessary help at the emergency room or call 911. If you’re not in immediate danger, but would like someone to speak with, you can reach the National Suicide Prevention Lifeline at 1-800-273-8255.
Hypnotherapist/Executive Coaches may also be available for additional time and cost, per Client’s request (for example, reviewing documents, reading or writing reports, engaging in other Client related services outside of coaching or hypnotherapy sessions).
If hypnosis or executive coaching package includes text, voice note, or Voxer support: In most cases, Hypnotherapist/Executive Coaches will reply within 48 hours of receiving Client’s Voxer messages, Voxer voice notes, text messages, or voice notes (omitting and excluding weekends and Friday after 5 p.m. Eastern Time). Alljoys Hypnotherapist/Executive Coaches are not available by Voxer between 5 p.m. Eastern Time each Friday and 9 a.m. Eastern Time the following Monday. Client is solely responsible for reaching out to Hypnotherapist/Executive Coaches with questions or to receive support. Client’s voice notes must be under two minutes and should be limited to one note at a time until Hypnotherapist/Executive Coaches respond. Alljoys Hypnotherapist/Executive Coaches may be unavailable by Voxer at times, including for vacations, holidays, and when attending to family requirements and, in such a situation, will endeavor to notify Client in advance.
Content
Client may download and/or print Alljoys content for Client’s own personal use. However, Client is not permitted to share, teach, sell, adapt, use, or redistribute any part of Alljoys’ Services, Products, or Program Materials, including recordings, for resale or mass reproduction purposes; for Client’s own business use; or for sharing this program with Client’s friends, family, colleagues, or any other individuals anywhere, whether in person, in private communication, or public communication. If such third parties would like access to these materials, they each must purchase their own license separately. They are encouraged to email office [at] alljoysco [dot] com for more information or a complimentary consultation. If Client or anyone else wishes to quote or paraphrase any content of any kind from Alljoys’ Services, Programs, Products, or Program Materials on any social media platforms, or to discuss same in any publication or mass media broadcast, Client may only do so if (a) Client gives clear attribution to Alljoys, (b) Client tags Alljoys’ or Hypnotherapist/Executive Coach’s social media profile on whatever social media platform is in question, and (c) Client accurately represents the Alljoys Services, Programs, Products, or Program Materials and/or any quotes or language of any kind being attributed to Hypnotherapist/ Coach or Alljoys.
Suicide & Abuse
As much as I want to protect privacy, there are times when I have to disclose information, even without your consent. If you are hurting yourself or someone else or if someone is hurting you, I may have to report it to local or state authorities. If you have a plan and access to a plan to hurt yourself and possibly die as a result, I am legally bound to notify the police/EMS closest to where you are. If I have reason to suspect elder or child abuse in any case – your own parent or child, or if you are under age 18 and I suspect you are being abused, I am also legally bound to report that to your local children and youth services (CYS). If I ever have to call police, EMS or CYS, I try to make sure that I discuss this with clients first and if possible, make a report with them. I do not want anyone to ever feel surprised or betrayed by these reports, but I also need clients to know that this is a legal requirement in all states that I must abide by. Because this is a legal mandate, I never charge a fee.
Confidentiality of Information
Clients have a right to expect that information revealed in sessions not be disclosed without extraordinary justification. The conditions that justify the release of information and by law must be reported to the appropriate agencies, are the following:
1. Knowledge of child abuse or neglect.
2. Knowledge of senior citizen abuse or neglect.
3. A client poses a serious risk of suicide and is an imminent danger to self.
4. A client poses a threat of imminent danger to another person.
5. A Judge, by issuance of a court order, may obtain information.
6. Report to law enforcement authorities knowledge of a felony that has been, or is being committed.
In other situations, signed authorization for release of information is required.
Payments
Payments are based on the agreement of the sessions or subscription of hypnotherapy sessions and executive coaching meetings purchased. I accept electronic payment services for those who want to use PayPal, Venmo, or Stripe.
By agreeing to participate in Alljoys, LLC services you have read and understood the rights and responsibilities in the Client Information, Participation Agreement, and Administrative Policy and you agree to abide by the administrative policy.
Thank you so much for your patience and understanding with the administrative policy in place, and please let me know immediately if you ever have any questions or comments.
Consent Form for Brain Stimulation or Transcranial Alternating Current Stimulation (tACS)
Alexandra Joy Seits, Alljoys LLC, DBA Inlet Behavioral Wellness, office@alljoysco.com
About brain stimulation with a Fisher Wallace device:
“Our patent-pending neuromodulation technology delivers low-dose, pulsed, alternating current stimulation (tACS) which, as a type of non-invasive brain stimulation, has been shown to induce neural plasticity and entrain neural oscillations.
We have conducted multiple clinical trials, including a bipolar II depression study at Mount Sinai Beth Israel Hospital, a Parkinson's study at the University of Maryland, three pilot studies during the height of the pandemic, a pivotal depression trial in 2022 that will be used to obtain a CE Mark in Europe for the acute treatment of depression in women, and a real world evidence anxiety study with the Seattle Police Department. We are preparing to launch a new depression study to obtain FDA approval for the treatment of depression.
The results of our most recent depression study are being prepared for scientific journal publication. Below is a graph that summarizes the results of our bipolar II depression study, published in the Journal of Nervous and Mental Disease in 2015.”
(www.fisherwallace.com)
“Clinically Proven
Fisher Wallace completed a 255-subject, triple-blind, randomized, sham-controlled trial that demonstrated rapid effectiveness in treating depression (highly effective in the first seven days) without causing serious side effects; results will be published in The Journal of Clinical Psychiatry. We are now collaborating with world-class researcher partners to conduct a final study for FDA approval. Building towards a future in which our technology is approved to treat a universe of conditions, Fisher Wallace recently completed an anxiety treatment study with the Seattle Police Department, and is currently applying for an Alzheimer’s research award.
The product should not be used on or near areas of the body, including the head, that contain implanted devices, such as stimulators, stents, or active or inactive implants such as deep brain stimulators and vagus nerve stimulators").
(www.fisherwallace.com)
“What does the product feel like?
Many customers do not feel the product at all, while some may feel a mild tingling at the sponge contact sites.”
Do not use this product if the following applies to you:
- Do not use this product around the Carotid sinus.
- If you have known or suspected heart disease, you should not use the product.
- The product should not be used by persons who have known or suspected trigeminal neuralgia.
- If you are pregnant, you should not use the product.
- If you have reacted poorly to the idea of electrical stimulation of any kind, you should not use this product.
Additional precautions:
- Discontinue use if your skin becomes irritated around either electrode site.
How does the product help me feel better?
The product uses a technology called Transcranial Alternating Current Stimulation (tACS), which modulates brain function and cognitive processes by entraining neural oscillations and inducing long-term synaptic plasticity.
Are there side effects?
Less than 1% of patients report a mild, temporary headache or dizziness when using the product.
Although not a side effect, improper use of the product may result in minor skin irritation beneath the electrode sites - this can occur if the sponges are not thoroughly wet before use or if the scalp and/or hair are not clean. Please watch the instructional video and read the instruction manual thoroughly before using the product.
The product has been on the market for decades without any reports of long-term negative effects. Many customers have used the device for years.”
Statement of Informed Consent
Informed consent for somatic work, especially brain stimulation or transcranial alternating current stimulation (tACS), is essential and out of respect for your right to choice and self-determination. Consent must be given voluntarily, knowingly and intelligently. Consent is active and ongoing, and you can change your mind at any time.
I confirm that I have read and fully understand the information contained in this document. I understand that brain stimulation or transcranial alternating current stimulation (tACS) are not a form of bodywork, physical rehabilitation, structural repair work, or any other form of medical treatment, but are instead body-oriented approaches to addressing neural network programming grounded in biophysiology and neuroscience that can be integrated into my overall plan for healing and wellness. I understand that I can undertake somatic work, coaching, hypnotherapy WITHOUT any brain stimulation or transcranial alternating current stimulation (tACS). Any and all questions I have regarding the contents of these documents have been answered to my satisfaction and I consent to receiving holistic somatic and subconscious work offered by Alexandra Seits. I have read and understand the above disclosure.
I have considered all of the above. I acknowledge having been sufficiently informed about brain stimulation or transcranial alternating current stimulation (tACS) and its potential risks and benefits prior to beginning use of brain stimulation or transcranial alternating current stimulation (tACS) sessions or tools, I have obtained whatever additional input and/or professional advice I deem necessary or appropriate for engaging in brain stimulation or transcranial alternating current stimulation (tACS).
I hereby consent to receiving brain stimulation or transcranial alternating current stimulation (tACS) sessions. I cknowledge and consent form is given of my own free will.