Client Consent & Release Form
Client Consent For Energy Healing Sessions & Events
By booking an energy healing session or participating in an event, you agree to the following Terms & Conditions:
I, the undersigned, understand that the energy healing session given involves a natural hands-on method of energy balancing for the purpose of pain management, stress reduction and relaxation. I understand that the energy healing services provided are not substitutes for medical or psychological diagnosis and treatment. I understand that Padma does not diagnose conditions nor prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of licensed medical professionals. I understand that Padma is not a medical doctor, licensed counselor or medical practitioner and has not represented herself in that manner. It is highly recommended that I see a medical professional for any physical or psychological ailments I may have.
Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Padma from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).
I certify that I voluntarily elect to receive energy healing services. Any application of recommendations and all participation is at my discretion.
I acknowledge that Padma has made no promises to me as to the outcome of an energy healing session. I verify that my decision to receive an energy healing from Padma is of my own free will.
I understand that there are no refunds for any purchases or services, and that Padma reserves the right to refuse service to anyone.
I have read this release in its entirety and agree to its terms. I understand that by signing this Release I am waiving and releasing considerable future legal rights. I verify that I am 18 years of age or older and mentally competent to enter this waiver. I am signing this release freely and voluntarily, under no duress or threat of duress, without inducement, promise, or guarantee being communicated to me. I acknowledge that by selecting “I understand and agree” on this form, I am verifying that I agree with the abovementioned and it is clearly understood by me.
We understand that sometimes life get busy. If you would like to reschedule, please contact our office at 615-708-9661 between the 10 am and 5 pm. We will try to accommodate you at your earliest convenience.
As per our late cancellation policy, you will be charged $50 of the total cost for canceling your appointment without providing a 24-hour notice. This amount must be paid in full before you can make your next appointment in future.