Studio Membership and Wellness Offerings

Agreement and Waiver

 

By Repose LLC and Repose Psychotherapy

(Owned and Operated by Mary Breen LCSW PLLC)

By checking the box, I understand that therapeutic movement and creative arts classes (including, but not limited to the following activities: dance movement, yoga, meditation, breathwork, and/or creative arts)  are not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any active program, including By Repose LLC and Repose Psychotherapy studio classes. I recognize that it is my responsibility to notify my instructor by private chat of any serious illness or injury before every class. I will not perform any postures, positions, or movements to the extent of strain or pain. If at any time during participation in a studio class, you feel discomfort or strain, gently come out of the posture and/or stop engaging in the activity. You may rest at any time during the class. It is important in dance movement, breathwork, meditation, and yoga that you listen to your body, and respect its limits on any given day. I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in any studio individual session, group, class, workshop, or event, or offering. 

Live Online and Livestream Classes

By participating in live online, livestream, or recorded movement, yoga, dance, meditation classes or any other wellness programs, I hereby release By Repose LLC and Repose Psychotherapy (owned and operated by Mary Breen LCSW PLLC) and any instructors and/or therapists from responsibility for any injuries I may sustain as a result of participation in the classes or programs presented by the studio, including any online pre-recorded or live streamed class. I am aware that the instructor cannot see me and may not be able to offer personalized instruction, and therefore I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the classes of programs offered through the studio. I accept that neither the instructor/therapist, nor the hosting studio, is liable for any injury, or damage, to person or property, resulting from taking the class. Those under 18 years of age must have this form acknowledged by a parent or guardian.

On-Demand Classes

By participating in on-demand recorded movement, yoga, dance, meditation classes or any other wellness on-demand or pre-recorded programs, I hereby release By Repose LLC and Repose Psychotherapy (owned and operated by Mary Breen LCSW PLLC) and any instructors and/or therapists from responsibility for any injuries I may sustain as a result of participation in the classes or programs presented by the studio, including any online pre-recorded class. I am aware that the instructor cannot see me and may not be able to offer personalized instruction, and therefore I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the classes of programs offered through the studio. I accept that neither the instructor/therapist, nor the hosting studio, is liable for any injury, or damage, to person or property, resulting from taking the class. I understand and authorize the $.01 processing fee to access on demand videos and authorize these charges.

By Repose LLC is a studio offering yoga-informed, dance movement, creative arts, and meditation group classes and wellness workshops and events. Some studio classes and offerings may be provided through Repose Psychotherapy (owned and operated by Mary Breen LCSW PLLC), but studio offerings should not be considered a substitute for the mental health services, treatment, or diagnosis provided within the scope of individual psychotherapy through Repose Psychotherapy (owned and operated by Mary Breen LCSW PLLC) or any other licensed mental health provider or clinic. Those under 18 years of age must have this form acknowledged by a parent or guardian.

Student Membership

Repose works with Wellfleet Health Insurance (serving the student bodies at NYU, School of Visual Arts, and Sarah Lawrence College) and Aetna Student Health (serving the student bodies at Columbia, Pratt, and FIT).. Repose will directly bill insurance for these drop-in group therapy class offerings. If you fail to notify us that your insurance has lapsed or is no longer active for any reason, you will be billed the full amount of the Repose Priority membership fee ($39/week). On-demand video library is available as part of your studio membership with a $0.01 processing fee not covered by insurance to access these classes.

Private Group Therapy Workshops

Please note that group therapy workshops (such as the DBT or Body Positivity groups) are not included with your student membership. These offerings may require a preliminary consultation to join and are subject to the standard copay per session as determined by your individual insurance provider. Additionally, these closed group therapy workshops have a 48 hour cancellation policy or you are responsible for the full amount of the group session. If you purchased a session package, a no-show or late cancellation will count as one used session. Thank you for respecting your provider’s time and the time that has been reserved specifically for you.

Private Individual Dance Movement, Art Therapy, and Therapeutic Yoga Sessions

Please note that individual Dance Movement, Art Therapy, and Therapeutic Yoga Sessions are not included with your student membership. These offerings may require a preliminary consultation to join and are subject to the standard copay per session as determined by your individual insurance provider. Additionally, these private, individual sessions have a 48 hour cancellation policy or you are responsible for the full amount of the session. If you purchased a session package, a no-show or late cancellation will count as one used session. Thank you for respecting your provider’s time and the time that has been reserved specifically for you.

Events

Please note that studio events are not included with your student membership unless otherwise indicated. Events may require pre registration and depending may be subject to a copay as determined by your insurance provider or may be ineligible for insurance reimbursement and therefore will be offered for a cost. Events will be subject to their own cancellation policy which, if registered, you will consent to.

Cancellation Policy and Etiquette

In order to value the time your therapist instructor has set aside for drop-in studio group therapy classes offered through your student membership, you should provide 24 hours advance notice of cancellation. For emergencies or when 24 advance notice is not possible for studio drop-in group classes, please notify your instructor through your account with Repose Studio. All bookings for therapy group classes may be managed via this account.

In accordance with our cancellation policy, clients are responsible for full payment of any group therapy workshop or individual sessions not cancelled at least 48 hours in advance of a scheduled session start time. If you purchased a session package, a no-show or late cancellation will count as one used session. Thank you for respecting your provider’s time and the time that has been reserved specifically for you.

Billing

For all administrative or billing matters, please contact: billing@byrepose.com and our office will respond during regular business hours between 9am and 5pm EST Monday-Friday. Please note that any credit card charges incurred may be reflected on your credit card statement as the following entities: By Repose Psychotherapy, By Repose LLC, or Mary Breen LCSW PLLC.

Crisis Services

Please note that Repose does not provide immediate, crisis intervention services. If you are experiencing a medical or psychiatric emergency, call 911 or use a free crisis resource available 24/7.

By checking the box, I acknowledge and accept the above conditions. I understand that Repose (owned and operated by Mary Breen, LCSW) will bill my insurance for the therapy group classes that I have booked or for individual therapy group workshops or sessions. If I fail to notify Repose that my insurance coverage has lapsed, I understand I will be responsible for the full membership fee of $39/week. Additionally, I agree to provide 24 hours advance notice to the best of my ability for cancellations of drop-in studio group therapy classes.

By checking the box, I understand that Repose (owned and operated by Mary Breen, LCSW) will bill my insurance for any closed group therapy workshop and private individual sessions I enroll in and that I will be responsible for all copayments at the time of service as determined by my insurer. If I fail to notify Repose that my insurance coverage has lapsed or changed, I understand I will be responsible for the full amount of any fees associated with the closed group workshop session and/or individual session that I have signed up for. Additionally, I accept responsibility for payment of closed group workshops, events, or individual sessions I have booked without 48 hours advance notice of cancellation.