Energy Medicine Professional Association Code of Ethics
As a member of EMPA, I agree and commit to abide by and uphold the following Code of Ethics:
1. Work within my Scope of Practice I will use my modalities within the scope of my training, experience, current licensing, and credentialing. I will accurately represent myself to the public in accordance with my credentials. If the needs of a client are beyond my abilities, I will refer the client to a competent professional for care. I agree to practice within the guidelines of this Code of Ethics.
2. Provide Respectful Care I pledge to treat clients with respect, courtesy, care, and consideration. I respect the client’s individuality, beliefs, inherent worth, and dignity. I commit to providing a comfortable and safe environment for clients. I respect the client’s right to be involved in their treatment, and I commit to empowering clients to give feedback and alter or discontinue a session at any time. I practice equality and acceptance, and work in partnership with clients to promote healing regardless of race, creed, color, age, gender, sexual orientation, politics, social status, spiritual practice, or health condition. The client’s inner process, spiritual practices, and pacing of healing are respected and supported.
3. Commit to Accurate Disclosure and Education I will inform the client of my educational and experiential background in any related credentials that I hold on an individualized basis, and consider the client’s expressed needs and personal situations. I will also provide an explanation of the treatment process to the level of the client’s understanding, and clearly and accurately inform the client of the nature and terms of the service before beginning any treatment.
4. Commit to Obtaining Informed Consent I recognize the client's right to determine what happens to his or her body. I will fully inform clients of choices relating to their care, and disclose policies and limitations that may affect their care to assist clients in making informed decisions. I will not provide service without obtaining the client's signed informed consent (or that of the guardian or advocate for the client) to the session plan.
5. Protect Confidentiality I affirm that I will protect client confidentiality at all times, will keep all client records in a secure and private place in accordance with state and federal regulations, and will only disclose information with the client’s written consent, within the limits of the law. I will document client health information and treatment findings appropriately according to my training and the setting. Information will be shared only with the client’s written permission.
6. Maintain Legal Compliance I agree that I am responsible for understanding and complying with local, state/province, and federal laws and regulations where I practice. I understand that I am expected to understand any legal restrictions or requirements with regard to any professional license or credential that I hold and to work within my scope of practice and to comply accordingly. I will maintain the appropriate business licenses according to my local and state/province requirements.
7. Commit to Professionalism I commit to maintain high standards of professionalism and integrity, and to serve the best interests of clients at all times. I will maintain and respect professional boundaries with clients at all times. I pledge to respect colleagues in my modality and other modalities and to model professional courtesy in my behavior and business practices. I will promote the Energy Medicine profession by committing to continuously improving my skills through education and practice.
Client Agreement for Services, Disclosures & Consent for Energy Medicine Sessions
Practitioner Name: Audrey Alfson, M. Ed.
Business Name: i.am.love. energy healing, LLC
Business Address: Hermosa, SD
Email: i.am.love.energyhealing@gmail.com
Definition of Energy Medicine
Energy Medicine is holistic integrative therapy intended to clear, balance and energize the human energy system in order to facilitate physical, emotional, mental, and spiritual self-healing.
The trained practitioner uses various energy medicine techniques with heart-centered intention. Energy medicine is intended to complement and not replace any prescribed medical care. Practitioners do not diagnose conditions or prescribe treatment.
Audrey Alfson, M. Ed., hereafter, “the Practitioner” has the received following education, training & credentials:
Bachelor of Science in Secondary Education, Montana State University, 1994
Master of Education in Curriculum and Instruction, University of Southern Mississippi, 2000
Holistic Health Counselor Certification, Institute for Integrative Nutrition, 2007
Level 1, 2, & 3 Spring Forest Qigong, Minneapolis, MN, 2008
Certified Level One Instructor and Healer, Spring Forest Qigong, Minneapolis, MN 2010
Level 4 & Master Healer, Spring Forest Qigong, 2012
Certified Emotion Code Practitioner, 2017
Certified Body Code Practitioner, 2018
Certified Laughter Yoga Leader, 2018
Reiki Master and Teacher, 2019
Certified Spring Forest Qigong Practice Group Leader, 2019
Advanced Ho’oponoono Practitioner, 2020
Certified Belief Code Practitioner, 2023
REMOTE Session Information
Remote energy medicine services involve 1) the use of secure interactive videoconferencing devices and equipment that enable the practitioner to deliver services to the client virtually when they are located at different sites; or 2) a “proxy” connection, where the practitioner provides services without talking to or seeing the client when they are at different sites.
TELEPHONE session information:
Telephone energy medicine services involve the use of a telephone connection where client and practitioner talk and the practitioner delivers services to the client.
IN PERSON Session Information:
In person energy medicine services involve an in person meeting between the client and practitioner at a specific time and place where services will be provided.
Payment is due when scheduling a session, unless other arrangements are made.
Standard 45 minute session rate is $100. Any session longer than 1 hour may be charged additional, prorated for time spent at $25 per 15 minute increment.
Discounted rates are available through the advance purchase of packages.
Appointment Cancellation Policy:
Client has the right to change or cancel an appointment up to the time of the scheduled appointment, without fee or forfeiture. No shows may be subject to forfeiture of session and payment or credit.
Client has the right to discontinue relationship with practitioner and will receive a refund of any unused portion of a package purchase that has not expired, when requested in writing.
The practitioner has the right to discontinue a relationship with a client, in writing. In this event, the practitioner will refund any unused portion of a package purchased that has not expired.
The practitioner is not a provider for any insurance carrier.
Confidentiality
All client information and records are treated in a confidential manner and no information will be released to anyone without my prior written consent, except in situations governed by law.
Agreement and Consent:
I understand that the same standard of care applies to a remote session as applies to an in-person visit.
I understand that the laws that protect the privacy and confidentiality of personal information apply to remote sessions.
I understand that I will not be physically in the same room as the practitioner. I will be notified of this, and my consent obtained for anyone other than the practitioner to be present or work with me.
Risks to Confidentiality: I understand that as remote sessions take place outside of the practitioner’s office, there is potential for other people to overhear conversations if I am not in a private place during the session. The practitioner will take reasonable steps to ensure privacy. It is my responsibility to find a private place for the session where I will not be interrupted. I also understand that it is my responsibility to protect the privacy of our session on the device being used.
Technology Issues: I understand that there are potential risks to using technology, including service interruptions, interception, and technical difficulties. For example, technology may stop working during a session, other people might be able to get access to our private conversations, or stored data could be accessed by unauthorized people or companies. If it is determined that the video conferencing equipment or connection is not adequate, I understand that either the practitioner or I may discontinue the remote session and make other arrangements to complete the session.
Disclosures
Energy Medicine practitioners do not diagnose conditions or prescribe treatments.
No specific claims will be made by the practitioner regarding results from the Energy Medicine sessions.
Goal(s) for our work together will be mutually identified as part of the assessment and clients have input in the goal-setting process.
Practitioner Liability Insurance:
Energy Medicine Professional Association (EMPA)
Hold Harmless Clause:
Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless, Audrey Alfson, from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).
I _________________ acknowledge by my signature that I have received and understand the Complementary and Alternative Health Care Client Bill of Rights and Terms of Agreement.
Signature_________________________________