Liability Form

                                                                                                  Liability Form 

I understand that CranioSacral therapy is a simple, gentle, hands-on energy technique that works with the subtle rhythm of the cerebrospinal fluid in the body and is used for stress reduction and relaxation. If I experience any pain or discomfort during my session, I will immediately inform the therapist so that the pressure and/or strokes may be adjusted to my level of comfort.

I understand that CranioSacral therapy practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional . I further understand that nothing said in the course of a craniosacral therapy session should be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a qualified medical specialist for any mental or physical ailment that I am aware of. I acknowledge that no assurance or guarantee has been provided to me as to the results of a therapy treatment session or series of sessions. I acknowledge that with any treatment there can be risks and those have been explained to me and I assume those risks.

I acknowledge and understand that the therapist must be fully aware of my existing medical and life conditions. I have disclosed to the therapist all of those medical and life conditions affecting me. It is my responsibility to keep the therapist updated on my medical history and any life conditions that may affect my treatment.

If I make any sexual advancements or innuendos the session will be terminated immediately without a refund.

I agree to give 24 hour notice if I choose to reschedule or cancel an appointment for any reason other than a family emergency or sudden illness. If I cancel without 24-hour notice or do not show up to my appointment I agree to pay the full cost of the craniosacral therapy session.

I understand that CranioSacral therapy can complement any medical or psychological care I may be receiving. I also understand the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long-term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself.

The information I have provided is true and complete to the best of my knowledge. I have read the above-noted consent and I have had the opportunity to question the contents and the therapy. By signing this form, I confirm my consent to treatment today and include consent for additional treatment proposed by my therapist. I understand that at any time I may withdraw my consent and treatment will be stopped

PRIVACY NOTICE: No information about any client will be discussed or shared with any third party without written consent of the client or parent/guardian if the client is under 18.