Let’s Get Started

I understand that the listening services I will be receiving from Jolanne Tierney are not offered as a substitute for professional mental health care or medical care and are not intended to diagnose, treat, or cure any mental health or medical conditions. I also understand that Jolanne is not acting as a mental health counselor or a medical professional.

I understand that listening is, at present, an unregulated industry and that Jolanne is not licensed by the State of California. I also understand that for all legal purposes, the services provided by Jolanne will be considered to be provided in the State of California.

I understand and agree that I am fully responsible for my well-being during my listening sessions, and subsequently, including my choices and decisions.

I understand that Jolanne’s listening service is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment, and I will not use it in place of any form of therapy.

I understand that Jolanne will only offer advise if I ask for her feedback. Her advise is solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to Jolanne to assist me in achieving such goals.

I understand that to the extent our work together, Jolanne is offering a safe space for me to express my feelings. To be heard without judgement. Jolanne is not promising outcomes.

I understand that Jolanne will protect my information as confidential unless I state otherwise in writing. If I report child, elder abuse or neglect or threaten to harm myself or someone else, I understand that necessary actions will be taken, and my confidentiality agreement limited in this capacity. Furthermore, if Jolanne is ordered by a court to provide information or to testify, she will do so to the extent the law requires.

I understand that the use of technology is not always secure, and I accept the risks of confidentiality in the use of e-mail, text, phone, Zoom, FaceTime and other technology.

I hereby release, waive, acquit, and forever discharge Jolanne Tierney from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of acts or omissions by myself or by Jolanne as a result of the advice given by Jolanne resulting from the listening relationship contemplated by this agreement. I further declare and represent that no promise, inducement, or agreement not expressed in this agreement has been made to me to sign this agreement.

This agreement shall bind my heirs, executors, personal representatives, successors, assigns, and agents.