Holistic & Wellness Services Informed Consent

I, understand that offers holistic therapies and non-traditional complementary interventions such as Reiki, Reflexology, Ionic Foot Detox, Infrared Sauna Detox Blanket ,all of which are intended to promote health and wellness, enhance relaxation, reduce pain, become relaxed and more comfortable with your own thoughts, letting go of tensions and apprehensions caused by stress, emotional barriers and physical /mental illnesses and offer a positive experience utilizing the concept of mind, body, and soul in treatment intervention.

I understand that my practitioner is trained Wellness Practitioner, and is not a massage therapist, chiropractic doctor, registered nurse, registered dietitian, nor a medical doctor. I understand, the practitioner is not qualified to diagnose, treat, cure, prevent or assess any disease, disorder or condition. I understand, the practitioner is not qualified to prescribe medication or dietary alternatives.

I understand that holistic therapy interventions are not a substitute for medical treatment or medications, and that it is recommended that I concurrently work with my primary healthcare provider for any condition I may have. I am aware that the practitioner does not diagnose illness or disease, does not prescribe medications, and that spinal manipulations are not part of holistic therapy.

I wholeheartedly understand that following any set regime does not promise any form or level of cure for any specific (or otherwise) condition. I promise to abide by any warnings or contra-indications given to me through consultation if products and services are used.

I understand that I am under no obligation to follow any recommendations for treatment given.

I have informed the practitioner of all my known physical and medical conditions, and I will keep the practitioner updated of any changes. I will notify the practitioner should I become pregnant of if I am trying to become pregnant.

I understand the practitioner and administrative staff may review my medical records and reports, but all of my records will be kept confidential and will not be released without my written consent.

I have read and understand this consent to treatment. I have been informed about the risks and benefits of holistic therapy procedures. I intend this consent form to cover the entire course of treatment for my present condition and for any future conditions for which I seek treatment.
Consent for Treatment for Reiki
I, the undersigned, understand that the Reiki session given involves a natural hands-on method of energy balancing for the purpose of pain management, stress reduction, and relaxation. I understand very clearly that these treatments are not intended as a substitute for medical or psychological care.
I understand that Reiki practitioners do not diagnose conditions, nor do they prescribe medicines, nor interfere with the treatment of a licensed medical professional. It is recommended that I seek a licensed health care professional for any physical or psychological ailment I have.
I understand that the practitioner will be placing hands on me or above me during the Reiki session. (Please choose an option)
I am ok with hands on treatment. I m ok with hands above treatment.
Nature of Reiki Treatments
I understand and believe that self-improvement requires commitment on my part, and that I must be willing to change in a positive way if I am to receive the full benefit of a Reiki treatment.
I acknowledge my commitment to my self-improvement process. I recognize that a Reiki treatment program must be followed to be truly effective, just as prescribed medication is only effective if taken as directed.
I acknowledge that the practitioner neither claims nor implies that any instruction, advice, counsel, suggestions, recommendations, services or products she or her representatives provide, whether in person, by mail, by telephone, or by internet, will cure, treat, prevent, or mitigate any disease condition; but are provided solely for the purpose of increasing energy, supporting the natural function of body systems and otherwise improving general health and fitness.
I understand Reiki is a stress reduction and relaxation technique that promotes healing on all levels when practices as hands-on ( as well as off-the-body in person or over distance) method that is always gentle, gentle-touch and relaxing.
I understand that there are no adverse effects to Reiki and no risk in regards to this service. I understand that I may feel a slight change of temperature in areas where hands are place and possible minor to little discomfort in areas due to healing properties but will receive a state a relaxation from process . I understand that I may be consumed with emotions during session which is common for some clients to encounter.
Reiki does not cure disease and is not intended to be the primary treatment for any health problem, but rather is a complementary therapy meant to support other treatment that is ongoing.
Reiki is not recommended for broken bones, acute pain, or any condition requiring immediate medical attention.
By checking this box signing this box, I consent and understand that I maydiscontinue a session or sessions at any time. If I have been diagnosed by a licensed health professional as having any disease, injury or other physical or mental condition, I understand that I should inform the person who made the diagnosis, about the session I will be receiving, and whether or not I intend to discontinue any treatment or therapy which had been previously ordered, prescribed or recommended by a licensed health professional. I understand that by discontinuing any such treatment or therapy, I assume responsibility for any negative outcome resulting from discontinuing that treatment or therapy.