Individual Meeting Contract & Consent Agreement

INSTRUCTIONS FOR USE:
This consent agreement applies to all email, phone and in-person correspondence with Shannon.

CONSENT AGREEMENT:
I/we acknowledge that I/we understand and agree with the following:

  • Shannon Cutts is not a licensed counseling professional.
  • She can offer guidance, mentoring and personal opinion ONLY from her own life experiences.
  • Her Key To Life materials/resources and ANY email, phone, or person-to person meetings are not meant to replace any professional medical or psychological advice/support necessary for the management of eating disorders, or any other emotional/mental conditions, and should never be construed as such.
  • I/we have voluntarily sought a meeting with Shannon Cutts and shall never hold her responsible for ANY action taken by himself/herself, or ANY of the parties involved in any of his/her meetings.

NOTE:
All communication with Shannon is confidential, UNLESS:
      a) it is determined that you are a danger to yourself or someone else;
      b) you disclose abuse, neglect, or exploitation of a child, elderly, or disabled person
      c) by law or institutional authorities, Shannon is instructed to disclose or release information

The Key To Life materials and resources are not meant to replace the medical advice and support necessary for the management of eating disorders or other emotional or mental conditions. Please seek professional medical advice.

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