CONSENT FORM

Client consents to treatment for self and understands that the services provided by the practitioner is intended to enhance relaxation and increase communication within the body.

 

Client understands that these services are not a substitute for medical treatment or medications. Client is aware that diagnosis is not given and medication is not prescribed.  Client agrees to continue to have regular medical check-ups as part of their overall health care plan.

 

Client understands that participation is voluntary and that at all times the client may choose to end participation.  Client understand that they may experience ‘healing reactions’ during the 24 to 48 hours following the services provided.

 

Client understands that any information exchanged during any session is educational in nature and is to be used at their own discretion. Client also understands that any information imparted during these sessions is strictly confidential in nature and will not be shared with anyone without their written permission. Client does, however, give the practitioner consent to use their case history and results without using their name.  Client understands that only the practitioner will have access to information in their file to enhance their healing.

 

Client understands that by providing this informed consent Client assumes full responsibility for services and Client holds harmless both the practitioner Darien Burton and the facility/location where the services are provided.

 

The Client agree to the terms and conditions set out by this consent form and certify that the above information is true and correct. The Client agrees to pay for distance sessions, should client request them.

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I understand that yoga & meditation includes physical movements as well as an opportunity for relaxation, stress reduction, and releasing muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, adjust the body and ask for support from my teacher. I will continue to breathe smoothly.

 

Yoga and meditation is not a substitute for medical attention, examination, diagnosis, or treatment. I understand that our instructors are not doctors. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Love Well Yoga, Vibe Clear or any of their teachers.

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