Practitioner’s Name: Raneesha Manoharan
By agreeing and signing this form I understand and agree to the following:
General
I understand that therapy and coaching are for ongoing support and are not intended for immediate crisis service. In urgent situations affecting my mental health or safety, I will contact appropriate services such as my GP, NHS 111, 999, local hospital, or Samaritans.
I will inform the practitioner of any changes to my mental, physical, or emotional health before or at the start of each appointment if any adaptations are needed.
I will inform the practitioner if I choose to end sessions and will give one session’s notice to allow for a supportive closure.
Effectiveness
I understand that effectiveness of these sessions depends on the support I receive as well as the initiative I put in.
I understand that sessions are not a substitute for clinical medical care provided by clinical professionals. While complementary somatic therapy and mind-body education can support positive change, any choices or changes I make are my personal and legal responsibility.
Where physical movement is concerned, I will assess my physical condition and carry out practices only within the range that is physically healthy and suitable for me.
Confidentiality
I understand that sessions are confidential unless prior consent is given, except in specific circumstances. The Practitioner has the obligation to break confidentiality if withholding information could put me or others in danger. Child protection overrules any confidentiality consideration.
I understand that aspects of my case may be discussed in the practitioner’s professional supervision with a qualified supervisor. This ensures the standard of quality and safety of care. This is on a firstname basis unless otherwise required.
Contraindications
I have declared any relevant conditions that I have including, in particular, any serious mental health condition, epilepsy or asthma.
Consented Physical Touch
As part of Somatic work, I am aware that there may be an offer of professional physical contact in the work together, which will always include psychoeducation, options and the client’s full right to opt in or out at any time.
Cancellations
Cancellation Policy:
48 hours’ notice of cancellation or rescheduling – no payment due
24 hours’ notice of cancellation or rescheduling – 50% payment due
Less than 24 hours – full payment due.
This helps keep fees at the lowest possible rate and covers the costs of planning, preparation, supervision, administration, record-keeping and other costs directly associated with my care even in my absence.
If I have circumstances which make it likely that I may have to cancel at short notice, I will be sure to discuss this with the Practitioner.
Regular attendance and continuity are an important part of creating a safe and reliable therapeutic container; where there are frequent cancellations or missed sessions, we may review whether the current therapeutic arrangement is supporting your needs and, where appropriate, consider alternative arrangements such as ad-hoc sessions.
Payments
I agree to pay in advance of or at each session. If this is not possible, I will inform the practitioner in advance or in exceptional circumstances at the beginning of our session.
Payment will be via Bank Transfer. Details will be sent via email.
Session Timing
If I arrive late, the session will still end at the originally agreed time. I understand that respecting both my time and the practitioner’s is part of my commitment to the work.
Sharing Stories With Care (You can opt out of this)
The practitioner may occasionally use anonymised examples from our work for educational purposes, such as talks, workshops, or writings, to help others connect with the power of somatic healing. These real-life examples gently expand healing in the world by making this work more relatable and human. My identity will always be protected, and all identifying details removed. If I prefer not to be included in this way, I can opt out at any time by letting my practitioner know this and my wishes will be fully respected.
Aftercare Recommendations
It is recommended to allow time to rest and reflect after each session, as emotional and somatic work can be mentally and physically demanding.
Healing Hangover
I understand that I may feel tired, emotional, or activated after sessions. This is a natural part of releasing long-held emotions. Prioritising rest and nourishment will support integration and recovery.
