INFORMED CONSENT
I hereby request and consent to receive and participate in an Intuitive Card reading, CranioSacral Therapy or Reiki Session, Physical Therapy Session or group class and other modalities within the scope of a Physical Therapist or Reiki practitioner (or on behalf of the client named below, for whom I am legally responsible)

I understand that methods of treatment may include, but are not limited to, physical therapy, somatoemotional release, craniosacral therapy, reiki, mindfulness, mindset coaching, tarot, and meditation. I understand that the techniques, along with their benefits and potential side effects, have been outlined and explained during my Initial Consult. I have agreed to receive and consent for the techniques I am receiving today and in future sessions. If my status changes and I require new techniques, I understand that I will be informed prior to their application.

I understand that the service I receive is provided for the basic purpose of relaxation, balancing energy flow, relief of tension, increasing mobility, increasing self-awareness, encouraging self-care practices, and improving overall well-being. If I experience any pain or discomfort during a session, I will immediately inform my practitioner.

I further understand that this treatment should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor or other qualified medical specialist for any mental or physical ailment that I am aware of. I affirm that they have stated all known medical conditions and answered all questions honestly. I agree to keep the therapist updated as to any changes in my medical profile and understand that there shall be no liability on the therapist’s part should I fail to do so.

I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment.

If I am a minor (under 18), I have the right to have a parent or guardian present during treatment. A parent or legal guardian's consent via signature will also be required prior to treatment in order for me to receive treatment. 

PAYMENT
Payment must be completed before your session begins. For online sessions or classes, you are required to do so via credit card at the time of booking. For in person sessions, payment will be accepted in the form of cash, check, or Venmo. If you need assistance doing so, please let your practitioner know ahead of time so it does not take away from your session time. 

CANCELLATION POLICY
Your appointment time is reserved just for you. A late cancellation or missed visit leaves a hole in the therapists’ day that could have been filled by another client. As such, we require 24 hours notice for any cancellations or changes to your session or class. Clients who provide less than 24 hours notice, or miss their appointment, will be responsible for the cost of the session or class. In the event of late arrival for your scheduled appointment, your therapist may need to deduct the amount of time you were late from your service, you will be responsible for the full cost of the service.

CONFIDENTIALITY
I understand that all information and dialogue exchanged during my session is confidential. I also know that if I want this information from these sessions to be shared with a third party, I need to inform my practitioner and sign a written consent form giving my practitioner permission to disclose services, status, techniques and plan of treatment to a third party. I do understand that requests from a lawyer are not law and that all requests for information will be first brought to my attention and disclosure approved by myself.

ADDITIONAL TERMS
I do not expect the practitioner to be able to anticipate and explain all possible side effects of treatment, and I wish to rely on the practitioner to exercise judgment during the course of treatment, which the practitioner thinks at the time, based upon the facts then known, is in my best interest. 

I understand that results are not guaranteed. I understand the practitioner may review my client records, but all my records will be kept confidential and will not be released without my written consent. 

By voluntarily signing below, I show that I have read, or have had read to me, the above consent to treatment, have been told about the risks and benefits and have had an opportunity to ask questions. I intend this consent form to cover the entire course of treatment for my present condition and for any future condition(s) for which I seek treatment.