{"content":[{"text":"I appreciate the opportunity to work with you today using “Emotional \n Polarity Technique”. Our sessions are confidential. My EPTworks™ \n client files are also confidential. Any personal correspondence between \n us about your session will be filed with this form.","bbox":{"left":0.147278,"top":0.26721,"width":0.6832349999999999,"height":0.08149999999999996}},{"text":"I may use your story without your name for teaching or referral \n purposes. You are welcome to spread the word about EPTworks™ and \n the good results you receive from it.","bbox":{"left":0.147278,"top":0.369332,"width":0.687206,"height":0.06119700000000006}},{"text":"I understand that my EPTworks™ sessions are confidential, \n as well as my personal information.","bbox":{"left":0.147278,"top":0.456021,"width":0.686629,"height":0.045335000000000014}},{"text":"Signature: ____________________________ Date: _________","bbox":{"left":0.147278,"top":0.571332,"width":0.677657,"height":0.02308600000000005}},{"text":"Print name: ___________________________","bbox":{"left":0.147278,"top":0.641332,"width":0.48995900000000003,"height":0.02308600000000005}},{"text":"We guarantee our services like this-if after your first session, you don’t think the \n EPTworks™ therapy will be beneficial, there is no charge.","bbox":{"left":0.147278,"top":0.71127,"width":0.660257,"height":0.03506500000000001}}],"images_bbox":[{"left":0.318258,"top":0.045586,"width":0.363922,"height":0.156364}],"images_bbox_not_text_overlap":[{"left":0.318258,"top":0.045586,"width":0.363922,"height":0.156364}]}