Notice of Privacy Practices
Protecting your confidential health information is important to us. It is our desire that you understand that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was written to protect the confidentiality of your health information and that we are committed to ensuring that your health information will not be shared with anyone who does not require it.
- We will use your health information only for purposes of providing diagnosis and treatment.
- We may share your health information with physicians, referring specialists or any other healthcare professional only with your permission.
These communications are an important part of our philosophy of partnering with our patients to be sure that you receive the best information and support that we can provide. Other than what is stated above or where Federal, State, or local law requires, we will not disclose your health information without your written authorization.
You may revoke authorization in writing at any time.
You have the right to obtain a copy of this notice from us at any time.
Quantum Vitality Disclaimer
Emotional Healing and Transformation – Disclaimer
The emotional healing and transformation work that Dr. Victoria Moore does is not psychotherapy. This work supports and provides powerful personal development for a fundamentally whole and healthy person who is not mentally ill and not psychotic. (Neurotic is okay.)
In a session, you may revisit painful or traumatic events from your past in order to help the body and brain resolve the trauma. You need to be able to tolerate some degree of emotional pain or stress in order to heal and transform. You are responsible for your own health and safety.
This work is aimed at helping you change habits of thinking and feeling in order to produce different results in your life. It is quite an active and co-creative process, so you are responsible for your own results.
By signing below, you certify that you understand and agree with this Disclaimer.
Quantum Vitality Office Policies
It is with great pleasure that we provide the services for you here at Quantum Vitality. We offer a variety of services, and tailor your treatment plan to you and your specific needs. I will separately provide some forms for you to complete, which will help me to begin developing your individualized treatment plan.
Our Office Policies
The following are some important policies. Please check each box to indicate that you understand and agree to the following office policies.
– During the first 20-30 minutes of the first session, Dr. Moore will give you the opportunity to decide whether you want to continue with this work. If you choose to discontinue the session, we will end there, with no charge.
– At the end of the first session, you will be given the opportunity to either pay for the single session, or purchase a package with no refunds.
Please check all boxes to indicate your understanding and agreement.