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Client Confidentiality Form 

I,  Christine Michele Murray , as your therapist, adhere to the EFTMRA Code of Conduct. I am qualified in Aromatherapy , EFT , Matrix Re imprinting and Reiki Master. As is your preference, I will use a combination of these skills to best suit your requirements. 

I agree to respect you, your values and belief system, and it is my commitment to you that we work together to find the best possible solutions for your concerns.   

Everything discussed in our sessions will remain strictly confidential. All notes will be with date and your initials only, they will be kept to a minimum and stored securely. These are for my own use only. If you prefer I do not take notes please inform me. I recognise that you may have private information of a personal nature which you would not like disclosed. This may include: sensitive personal matters, private issues from the past, future plans, business affairs, financial information, job information, personal information and any other information that you consider is confidential. I confirm that I will not, either directly or indirectly, use any such information or disclose it to anyone else without direct permission from you, the client, except under the following circumstances: 

  • There is the risk of harm to self and/or to others

  • The Terrorism Act (2000) requires disclosure of any suspicion of acts of terrorism

  • The Drug Trafficking Act (1996) requires disclosure to the police any information concerning an individual making money through drug trafficking 

  • If I receive a court order 

Length of session will be as agreed in advance between us. Should you arrive late for a session the session will still finish at the regular time unless previously arranged.  24 hours notice is required for cancellation otherwise the session remains payable or is deducted from session block (where client had booked a package), unless otherwise agreed at my sole discretion.


I welcome your feedback throughout our work together so that we do find the best balance of pacing and therapy style to resolve your issues as gently and swiftly as possible. 

Thanks for submitting!

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