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Systemic Family Constellations
Participant Agreement and Waiver Form


The practice of Systemic Family Constellations is an educational experience that is not licensed by the state of California or any governmental body. The Facilitator does not give any medical diagnosis as it is meant to be complementary to, not a substitute for, licensed medical services.

By participating in Systemic Family Constellations, I understand that strong and possibly unpleasant feelings and emotions may arise. I hold the Facilitator, Christina Shonkwiler, harmless and release her from liability. By agreeing to this form, I am consenting to take responsibility for such manifestations that may arise on my part during Systemic Family Constellations, and confirming that I understand this risk. I do not have a mental or physical condition that would make this inadvisable.

These sessions are confidential, and the Facilitator pledges to uphold high ethical standards. Professional services will be given in accordance with training in Systemic Family Constellations framework and technique.


Participant Signature: _____________________________________________________

Date: ____________________________________________

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