Somatic Clearing™ Waiver & Safety Disclosure
1. Scope of Services
* I understand that I may participate in one or more of the following practices as part of my work with Roshelle Celeste:
- Nervous system education and regulation practices
- Functional or gentle breathing techniques
- Conscious connected breathwork
- Activating breathwork techniques
- Somatic awareness and release exercises
- Guided visualisation
- Emotional processing
- Somatic coaching
- Deep relaxation and meditation
*I understand that not all practices may be appropriate for me, I have been informed of potential contraindications, and participation in any specific technique is voluntary.
*I understand the practitioner does not diagnose, treat, cure, or prevent any medical or psychological condition and is not acting as a licensed medical or mental health provider unless explicitly stated.
*I understand these services are educational and experiential in nature and do not replace medical care, psychotherapy, or psychiatric treatment.
2. Voluntary Participation & Right to Opt Out
* I understand that:
- I may choose to decline or modify any practice.
- I may stop participation at any time.
- I am encouraged to communicate openly if a practice does not feel suitable for me.
*I agree to inform Roshelle Celeste if I feel uncomfortable, overwhelmed, scared, experience pain, or feel unable to continue.
3. Potential Effects
*I understand that somatic and breathwork practices may produce a range of physical, emotional, or psychological responses, including but not limited to:
- Tingling or numbness
- Tetany
- Muscle tension or release
- Dizziness or light-headedness
- Changes in body temperature
- Emotional release (including sadness, anger, fear, grief, joy)
- Memory recall
- Altered states of awareness
*I acknowledge that experiences vary between individuals and that no specific outcome is guaranteed.
*I understand it is my responsibility to stop the practice and inform the practitioner immediately if I feel uncomfortable, overwhelmed, scared, experience pain, or feel unable to continue.
4. Contraindications & Health Disclosure
*I confirm that I have disclosed any relevant medical or psychological conditions, including but not limited to:
- Cardiovascular disease or high blood pressure
- Bradycardia
- History of stroke, aneurysm, or heart arrhythmia
- Epilepsy or seizure disorders
- Severe asthma or respiratory illness
- Pregnancy
- Recent surgery, concussion, or significant injury
- Detached retina or glaucoma
- Osteoporosis
- Bipolar disorder, schizophrenia, psychosis
- Active suicidal ideation
- Severe dissociation or complex PTSD
- Dizziness
- Recent surgery
*I understand that certain practices (particularly activating or intensive breathwork techniques) may not be appropriate without medical or psychological clearance.
*I acknowledge that I may still participate in other suitable practices even if some techniques are contraindicated.
*I accept full responsibility for providing accurate and complete health information.
*I acknowledge that it is my responsibility to promptly inform the practitioner of any changes to my physical or psychological health, medical diagnoses, hospitalisations, injuries, surgeries, or prescribed medications (including changes in dosage) that may affect my ability to safely participate in somatic or breathwork practices throughout the duration of our work together.
*I understand that if I have asthma, I need to bring my inhaler to all sessions.
5. Altered States & Emotional Processing
*I understand that certain somatic and breathwork practices may access deep emotional or physiological responses.
*I acknowledge that:
- Emotional processing may continue after a session.
- I may notice shifts in mood, energy, or awareness as part of this process.
- The practitioner will provide guidance and suggestions to support integration following sessions.
*I understand that I am responsible for engaging in appropriate self-care and for communicating if I require additional support.
*If I experience distress beyond my capacity or feel that I need further assistance, I agree to inform the practitioner and seek additional professional support where appropriate.
6. Personal Responsibility
*I understand that:
- I am responsible for monitoring my own physical and emotional capacity.
- I will immediately communicate if I feel distress beyond my comfort or ability.
- The practitioner cannot guarantee specific results or outcomes.
- My participation is voluntary and undertaken at my own risk.
7. Online Participation
* I confirm that:
- I am in a safe, private environment.
- I will not drive, operate machinery, or participate in water during breathwork.
- I have access to appropriate support if needed after a session.
8. Assumption of Risk & Release of Liability
*I understand that somatic and breathwork practices carry inherent risks.
*I voluntarily assume full responsibility for any physical, emotional, or psychological responses arising from participation.
*I hereby waive Roshelle Celeste, any employees, associates, representatives, agents, independent contractors and any related entities from any and all claims, costs, liability and expense for any injury, loss or damage (including death) whether known, anticipated or unanticipated, negligent or intentional acts or omissions arising from my participation in breathwork.
9. Confidentiality
*All information shared during sessions will remain confidential.
*There may be rare instances where this may not be the case, for example if there was
information shared where you or someone else was at risk of significant harm. This would
always be discussed with you directly unless it would further increase risk. For further
information please discuss directly.
10. Acknowledgement & Agreement
*By signing below, I confirm that:
- I have read and understood this agreement.
- I have had the opportunity to ask questions.
- I am in good health and able to participate in this activity.
- I do not have any physical or mental conditions which would impair my ability to engage in this activity or which would otherwise endanger my health or which would cause any risk of harm to myself.
- I understand that this is not medically supervised.
- I understand I may opt out of any specific practice.
- I have hereby been advised that I should talk to my doctor, physician, and/or psychotherapist if I have any questions about my physical or mental ability to safely participate in Somatic Clearing™.
- If I have chosen not to obtain a physician’s consent prior to my participation I hereby agree that I am doing so voluntarily and solely at my own risk.
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Information & Nature of Services
The services offered through Roshelle Celeste are holistic, educational, intuitive, and spiritually oriented in nature. These offerings are designed to support self-awareness, emotional processing, nervous system regulation, embodiment, energetic exploration, and personal growth.
Services may include:
・Somatic and embodiment practices
・Breathwork and nervous system support
・Meditation and guided visualisation
・Inner child, identity, and ancestral exploration
・Intuitive guidance and energetic reflection
・Spiritual practices, ritual, and integration support
・Coaching, mentorship, and educational teachings
This work is designed to support deeper connection with the body, emotions, patterns, inner wisdom, and lived experience.
Intuitive & Energetic Practices
Intuitive guidance and energetic practices are offered as supportive tools for reflection, self-inquiry, and personal exploration. Experiences and interpretations are naturally subjective and may vary from person to person.
Clients are encouraged to use personal discernment when engaging with any insight, guidance, or spiritual perspective shared during sessions or programs.
Scope of Support
These services do not replace medical care, psychotherapy, psychiatric care, or crisis support.
While emotional processing may arise within sessions, the work is not intended as diagnosis or treatment for mental or physical health conditions unless otherwise explicitly stated within the practitioner’s licensed scope.
Additional professional support may sometimes be beneficial alongside this work.
Integration & Personal Responsibility
Healing and personal growth often continue unfolding beyond the session space. Integration, self-reflection, rest, boundaries, and ongoing support practices can all play an important role in this process.
Clients remain responsible for their own choices, actions, wellbeing, and participation throughout their work with Roshelle Celeste.
Communication & Container
A safe and supportive environment is built through mutual respect, honest communication, and clear boundaries.
Messages and communication are responded to within reasonable business hours and are not intended for emergency support or crisis care.
If immediate medical, psychological, or emergency assistance is needed, appropriate emergency or licensed support services should be contacted.
Consent & Agreement
By checking the box below, I confirm that:
・I have read and understood the information above.
・I understand the nature and scope of these services.
・I voluntarily choose to participate in these offerings.
・I take responsibility for my own wellbeing and participation throughout this process.
