Informed Consent

Drift with Dr. Kimberly Lemke, P.C.

By agreeing to purchase the Five Part Course with Workbook, “Drift with Dr. Kimberly Lemke, P.C.” from Dr. Kimberly A.

Lemke, P.C. and Drift, Inc., understand and agree to the following:

1. I acknowledge that “Drift with Dr. Kimberly Lemke, P.C.” is a program designed to help people who have trouble sleeping address issues that may be affecting sleep in order to fall asleep easier, stay asleep, and feel more well rested and energized. I understand that the amount of sleep improvement will vary by individual and that results are not guaranteed.

2. I acknowledge that this course is made available by Dr. Lemke pursuant to her training as a sleep science coach and that her offering this course is not the practice of clinical psychology.

3. I acknowledge that although Dr. Lemke is a licensed clinical psychologist in the State of Illinois, through the purchase of this course I am not entering into a doctor/patient relationship with Dr. Lemke.

4. I acknowledge that I have not been diagnosed by Dr. Lemke with any psychological disorder and that this course and workbook do not constitute “treatment” of any psychological condition which may exist.

5. I agree to hold Dr. Kimberly A. Lemke, Dr. Kimberly A. Lemke, P.C.

and Drift, Inc. harmless from any ill effects, however unlikely, that I may experience as a result of taking this course.

6. I acknowledge that all of the above stated information also applies to any promotional services made available by Dr. Lemke including but not limited to individual or group consultations/trainings/workshops offered.

7. I acknowledge that I have fully read this Informed Consent and that I understand it. If I have any questions or concerns regarding this

Informed Consent, I know that I can reach out to Dr. Lemke at

[email protected].