The Imagination Process™ Registration

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Welcome! You are about to participate in The Imagination Process™ because you desire some kind of change or transformation in your life. The Imagination therapy team looks forward to meeting and working with you for this transformational adventure. As part of registration for this process, we ask that you read and complete this form to officially register and to understand more about the process and our policies.
 
The Imagination Process is an “experiential process” asking you to participate at the highest level you are able. The work is designed to access any unconscious energy, pain or trauma stored in your memory and in your body so that you may live a life of joy, peace and love and reverse any negative patterns that no longer serve you.
 
Experiential processes include writing, art, movement, dance, breathwork, meditation, sound, regression, visualization and drama therapy. These processes allow one to feel, experience, express and release pain from inside the body. Some of the expressive therapeutic arts also involve touching or being touched by the facilitator or the group. Said touch may include handholding, hugging, tapping, learning on one another, and similar non-sexual touching. Our therapeutic team will take all normal precautions to maintain physical safety during sessions but client must assume all risks of accident resulting from unintentional movements.
 
Our policies and process apply to those engaging the Imagination Process Virtual Reality Process as participants also engage experiential processes from home, office or other safe and sacred space that is created; with special attention given to Virtual Reality Agreements.
 
Please be aware that The Imagination Process serves as a practicum/training for students at Soul Studies Institute, (our not for profit educational institute offering coursework, internships, supervision and continuing education to students in the Life Coach or Drama Therapy training program.) Please be informed that students in training participate in team meeting planning, lead small groups during the process and are involved in all aspects of the process, and therefore are privy to certain important information concerning your life and family history.
I have read the above description of The Imagination Process and I give my consent to participate in this work. *

Program/Tuition Options and Agreement

Below are options concerning The Imagination Process program you have discussed with your therapist. For some of you, insurance may be covering your process or a portion of your program and/or you may be using insurance with a co-pay. We are happy to create a payment plan for you if needed. Please discuss this with your therapist and/or our business office. For those with payment plans, please be advised: it is our policy that you pay for your program in full even after you complete your process. PLEASE INDICATE BELOW YOUR PROGRAM CHOICE AND ANY OTHER CHOICES THAT APPLY TO YOU: *
Refund Policy:

No monetary funds will be refunded. Participants unable to complete the process will be given the opportunity to do individual sessions and/or other transformational workshops if a credit is applicable.

Participants are responsible for payment of the full fee for the process even if a weekly group or workshop is missed; tuition is for the “program” rather than individual weeks or session.
I have read the tuition and refund policies above and agree to this financial investment in myself. *
Here are links to the Payment Portals for tuition payment.  Please be sure you have discussed your tuition and payment plan/options with our business office (Heartsong: 772-579-3495) before completing the payment portal.
 
You will see a regular payment link for various agreed upon payments; and a special payment portal for those authorizing weekly drafts.
 

Consent for Treatment

Your signature below indicates that you understand the work you are about to do, and give consent for treatment.
 
1.  I hereby authorize Solutions Center for Personal Growth, Inc. and/or Therapetee PLC in Soulville to administer treatment to me (or my child), which may include psychotherapy, expressive therapy and or educational services.
 
2.  I understand that this work is experiential group process designed for full expression of the whole and true self. I, the undersigned, hereby consent to participation in the psychotherapeutic use of the expressive therapies.  I am aware that all of these agreements apply to Imagination Virtual Reality Process.
 
3.  I understand that this is a process, the intention of which is the furthering of my emotional, mental, physical and spiritual health. I understand that this process may involve touching or being touched by the therapists or touching or being touched by group members as stated above. I understand that the therapists will take all normal precautions to maintain physical safety during sessions but that I must assume all risks of accident resulting from unintentional movements.
 
4. I understand that student interns from Soul Studies Institute are part of the planning and facilitation of my process, and give permission to release information about myself to the therapy team.
 
5. I will be responsible for all charges for services provided by Solutions Center for Personal Growth, Inc. and/or Therapetee PLC as described above and understand the refund policy.
 
6. I understand that if I (or my child) am committed to this process and fully participate in all the experiences and activities, my life may become incredibly joyful, meaningful and wonderful.
 
7.  I herby certify that I have read this entire form and that I have discussed any concerns related to any of its provisions with my therapist to my satisfaction. I agree and give my consent for treatment. I am excited about my transformation!
By signing this form you are indicating that you understand and agree with our policies and look forward to your own healing and transformational work.
Your Signature Completes Your Registration *
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