For your protection and mine, before you use TAT, whether facilitated by certified TAT Trainer Jeanine DuBois or on your own, please read the following. Once you have understood it, if you agree, please sign below, and you are then welcome to participate in using TAT with Jeanine.

I understand and agree that

• Information provided by Jeanine is educational and provided only as general information. I will be introduced to a modality created and developed by Tapas Fleming called Tapas Acupressure Technique^® or TAT^®, which originated in 1993. Since TAT continues to evolve, I am encouraged to visit Tapas’ website <www.TATLife.com> for the latest free download of her “How to Do TAT” booklet. This can also provide a preview of the TAT process.
• Because TAT is a relatively new healing approach and the extent of its effectiveness, as well as its risks and benefits are not fully researched, I agree to assume and accept full responsibility for any and all risks associated with doing TAT.
  
• In doing TAT, other emotional and physical sensations or additional unresolved memories may surface or continue to surface, indicating other issues may need to be addressed.
• Previously vivid or traumatic memories may fade. This could adversely impact the ability to provide detailed legal testimony regarding a traumatic incident.
• No medical diagnosis, prognosis, treatment, cure, or prevention is expressed or implied by TAT or by Jeanine DuBois. TAT is not a substitute for medical or psychological treatment. Jeanine makes no warranty, guarantee, or prediction regarding any outcome from using TAT for any particular issue. Jeanine accepts no responsibility or liability for the use or misuse of TAT information provided.
• Information presented by Jeanine is for my own personal use. I understand that if I want to share TAT with friends and family, I can direct them to the TAT website <www.TATLife.com> or to a certified TAT Professional. In order to use TAT with others professionally, I understand that I need to become a certified TAT Professional.
  
• If any court of law rules that any part of this Disclaimer is invalid, the Disclaimer stands as if those parts were struck out.
  

• I am in total charge of my experience with TAT.
• Anything addressed or revealed is received by Jeanine with respect and is held in honored confidence.
• So that she can be of maximum support to me, I will communicate to Jeanine:

• my comfort preferences (temperature, lighting, water, restroom) as well as physical or emotional sensations,  which seem important to express, whether surprising, uncomfortable, or delightful
• any pertinent insights, observations, or requests - any guidance I sense about what might be helpful

By signing below, I acknowledge and agree to

• all statements herein
• my choice to utilize TAT of my own free will
• my right to cease using this approach at any time
• I agree to take full responsibility for my self-care in the physical, mental, emotional, and spiritual dimensions of my life and to seek professional advice as appropriate before implementing any protocol or opinion from this instruction, including TAT, and before making any health decision.

Session Participant: X____________________________________________________ Date____________________

Name (printed)_________________________________________________________________________________

Address_______________________________________________________________________________________

City___________________________________________________ State____________ Zip code _______________

Country________________________________________________ Phone__________________________________

Email_________________________________________________________________________________________


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