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Client - Practitioner Agreement (Waiver and Release Form)

Please read the below information carefully, and indicate at the bottom your agreement. This agreement is compiled according to California Senate Bill SB 577 for complementary and alternative health care practitioners. Thank you!


Iryna Malakhivska, hereinafter referred to as “Practitioner” is not licensed as a healing arts practitioner by any state. Practitioner agrees to provide professional services in accordance with acquired training and experience giving undivided attention during scheduled consultations to facilitate Client's benefits. Services utilize the framework and techniques of Family Systemic Constellations work and Closing the Bones ceremony. 

Services to be provided do not include the practice of medicine, as Practitioner is not a licensed physician. These services are non-diagnostic, and are complementary to the healing arts services that are licensed by the state. The primary purpose of licensing laws for legally defined Healing Arts and Mental Health professionals is to protect public health and safety. Accordingly, Family Constellations and Closing the Bones ceremony Practitioners are not issued licenses by any state governmental agency to engage in their professional services.

I, Iryna Malakhivska, have acquired the following education, training, experience, and qualifications to perform the services offered to my Clients:

- Family Constellations Facilitator training (100+ hrs) at Convivium Constellations, Placitas, NM and online, 2024-2025. 
- Closing the Bones, Swaddling Ceremony facilitator training (72 hours) at Taya Shopen, Earthy Birth LLC, Talent, OR, 2023-2024.
- Certified Scrum Product Owner (15 hours) at Grow-Lean LLC, San Jose, CA, 2024.
- Dream Analysis at This Jungian Life Dream School, online, 2023-2024.
- Other therapeutic modalities for Continuing Education since 2021, online, (50-100 hours annually).

Email Services Between Sessions

I am happy to respond to simple questions following a session or constellation, and I always want to know if there are any concerns. However, this work requires time for integration. I cannot provide counseling services by email between sessions.

Payment Policy

Fees are due before or at the time that the service is provided. Payment plans are available by request and must be agreed to in advance.


I, Client, have read the above policies and disclaimer and I am aware that Practitioner’s consultations are not intended to be psychotherapy or any other type of licensed therapy or medical service. Additionally, I have received a copy of this disclosure and understand the information described above. By signing this waiver and release, I hereby assume the risk of my participation in a Family Constellation and/or Closing the Bones session. I, on behalf of my heirs, guardians, and legal representatives, do hereby release Iryna Malakhivska from any claims, suits, demands or actions arising from or growing out of my participation in a Family Constellation and/or Closing the Bones session. 


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