[ultimate_modal modal_title=”Health Consent Form” btn_txt_color=”#ffffff” btn_text=”Health Consent Form” modal_size=”medium” el_class=”health-consent”]
Health Consent
- I understand that it is my choice to receive and participate in a massage, stretching, physical therapy, yoga class, acupuncture treatment, guided meditation, fitness training, group class, chiropractic adjustment, wellness lecture or other service provided by DeNatura Wellness.
- I realize the treatment / class is for my wellbeing including stress reduction, help with trauma/addiction, tension relief, increase fitness and/or energy flow.
- I understand my practitioner does not diagnose illness, disease or any physical or mental disorder nor does he/she prescribe pharmaceuticals.
- I acknowledge that these treatments are not substitutes for medical examination and diagnosis, for which I will see my primary care provider.
- I will immediately inform the practitioner if I feel pain or discomfort, if I feel my wellbeing may be compromised, or if I feel the premises or equipment is
unsafe.
- I understand that I may experience residual pain, discomfort and/or bruising after a treatment.
- Payment is deemed earned in full upon the commencement of services provided by DeNatura Wellness.
- I understand that any illicit or sexually suggestive remarks or advances made by men will result in immediate termination of my treatment/class and no refund or credit for such session will be provided.
- I understand and agree to be contacted by DeNatura Wellness with information about their services.
- I understand and agree to be liable for a one thousand dollar penalty in the event I contact or solicit services directly from the therapist/instructor without DeNatura Wellness Director’s written consent, and that services may be
permanently terminated should this occur.
- I understand and agree to all the above and waive any right I have to claim any damages or other loss or liability from DeNatura Wellness Officers, Therapists, Instructors, Speakers, Teachers Employees, Officers and/or Agents, arising out of any accident or injury, whether the same results from any active or passive negligence of DeNatura Wellness Officers, Therapists, Instructors, Speakers, Teachers, Employees, Officers and/or Agents.
[/ultimate_modal]