LOTUS OASIS COUNSELING AND WELLNESS, LLC
Guided Meditation Group — Waiver, Release, and Acknowledgment
(Example)
Purpose of the Group
Lotus Oasis Counseling and Wellness, LLC (“Lotus Oasis”) offers a free, voluntary guided meditation group, held weekly on Friday mornings. This group is facilitated in the spirit of Zen Buddhist dharma and centers on mindfulness, self-reflection, and accessing inner peace.
This group is offered as a community wellness practice. It is not psychotherapy, counseling, or any other form of clinical treatment, and participation does not create a client, patient, or therapeutic relationship with the facilitator or with Lotus Oasis, even for individuals who are also clients of the practice in a separate, individual capacity.
Voluntary Participation
Participation in this group is entirely voluntary and free of charge. You may join or leave a session at any time, may keep your camera off, and may use a preferred or non-identifying name during the group. You are free to participate in as much or as little of a session as feels comfortable, including simply listening without speaking.
No Clinical or Emergency Services
This group is not a substitute for individual therapy, medical care, or crisis intervention, and it is not monitored or staffed as an emergency or crisis resource. If you are experiencing a mental health crisis or emergency, please contact 988 (Suicide & Crisis Lifeline), call 911, or go to your nearest emergency room.
Acknowledgment of Risks
Meditation and mindfulness practices can, for some individuals, bring up strong emotions, memories, or physical sensations, particularly for those with a trauma history. By participating, you acknowledge:
• Meditation is a personal practice, and your experience of it is your own responsibility.
• You may pause, rest, open your eyes, or step away from the practice at any point without explanation.
• The facilitator is providing general guidance in a group wellness setting, not individualized clinical assessment or treatment.
• If uncomfortable feelings arise during or after a session, you are encouraged to seek support from your own therapist, physician, or another qualified professional.
Group Confidentiality (Informal, Not Clinical)
Because this is a group setting rather than an individual clinical service, standard therapy confidentiality protections do not apply. Participants are asked, as a courtesy, to keep what is shared by others in the group private. Lotus Oasis cannot, however, guarantee the privacy practices of other participants and is not responsible for disclosures made by group members outside the session.
Release of Liability
In consideration of being permitted to participate in this voluntary, no-cost group, I release Lotus Oasis Counseling and Wellness, LLC and its facilitator from any and all claims, liabilities, or damages arising from my participation, to the fullest extent permitted by Ohio law. I understand this release does not apply to gross negligence or willful misconduct.
Acknowledgment
I have read this document, understand its contents, and voluntarily agree to participate in the Lotus Oasis guided meditation group under the terms described above.
Participant Name (or preferred/group name): ___________________________________
Signature: ________________________________________
Date: _________________________