Please specify below any difficulties or traumatic events that you have experienced in the last 6 months, which you may be dealing with during the Mindfulness, Compassion or Awareness in Action Course:

I understand that the Mindfulness, Compassion and Awareness in Action Courses being offered over the 8-week period are not a substitute for medical or psychological care.  I understand that my mindfulness teacher is not a qualified psychologist, psychiatrist, or medical doctor. Her expertise is based on her own ongoing personal experience as a mindfulness practitioner, as well as her doctorate and the training she has undergone to teach mindfulness.  

If I am currently seeing a psychologist, I have discussed my attendance on this course with him/her and s/he has agreed that it is appropriate for me to attend the training.  I confirm that I will notify my mindfulness teacher of any psychological difficulties, physical difficulties and if I have experienced a traumatic event in the last 6 months, in the space below.  I agree to inform the mindfulness teacher of any changes in my health and medical condition.  I understand that there shall be no liability on the mindfulness teacher’s part should I forget to do so.  

I agree to use the course materials, both the written and audio, for personal use only. I understand that this course is designed to develop my own personal mindfulness practice, and does not qualify me to offer mindfulness courses.

By signing this release, I hereby waiver and release my mindfulness teacher from any and all liability that I may deem relating to the mindfulness practice.