Thank you for choosing The Sacred Technician for your sacred transformational session! It is my goal to provide you with the most therapeutic experience possible. Please answer the questions below so that I can thoroughly address your needs. Rest assured that your information is confidential. I would like to hear your questions, comments, and suggestions. You’re invited to share them in the way most comfortable for you, either in person, over the phone, or by email.
Late Arrivals
If you arrive late, your session may be shortened in order to accommodate others whose appointments follow yours. Depending upon how late you arrive, it will be determined if there is enough time remaining to start your session. Regardless of the length of the session actually given, you will be responsible for the cost of the session. Out of respect and consideration for your practitioner and other customers, please plan accordingly and be on time.
Consent
If I experience any pain or discomfort during the session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that any sacred session 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 of which I am aware. Because massage or massage-like therapies should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioners part should I fail to do so. This is a transformational sacred experience, and any sexual remarks or advances will terminate the session, and I will be liable for payment of the scheduled session. I understand the practitioner reserves the right to refuse services to me for any reason that she deems necessary.
Male and female genitalia will not be exposed or touched at any time. You will be draped with sheets/blankets at all times during your session. This is for your privacy, comfort, and our protection.
Informed written consent must be provided by a parent or legal guardian for any client under the age of 17.
PLEASE READ CAREFULLY BEFORE SIGNING THIS FOLLOWING RELEASE.
I understand that The Sacred Technician does not provide medical treatment but provides offerings for my own sense of wellbeing and relaxation. I understand that The Sacred Technician recommends that I consult with a physician for any ailments that I might have. Any suggestions made by The Sacred Technician or any associates or employees are recommendations only and not medical prescriptions.
For and in consideration of The Sacred Technicians’ offerings and the use of the facility. I agree to the following:
Assumption of Risk.
I understand that using the facility and receiving any offerings provided by The Sacred Technician involves risks and dangers that could result in personal injury, death, property damage, or loss. I also understand that such injury or loss may be caused or contributed to by the negligence or carelessness of others. I acknowledge and assume these risks and any resulting personal injury, death, property damage or loss.
Waiver and Release Liability.
I discharge, undertake not to sue, and hereby release The Sacred Technician, its related companies, employees, representatives, agents, officers, and directors from any and all claims, costs, demands, causes of action, and liability of any kind whatsoever for personal injury, death, property damage or loss that I may now or in the future have, known or unknown, which in any way results from or arises out of or in the course of my receiving any offering by The Sacred Technician.
Indemnity.
I will hold harmless and indemnify The Sacred Technician, its related companies, employees, representatives, agents, officers, and directors for any and all claims of liability for damage, personal injury, or death resulting from, arising out of or in the course of my using the facilities or receiving any offerings by The Sacred Technician.
Enurement.
This Waiver, Indemnity, and Release of Liability Agreement benefits the The Sacred Technician, its successors and assigns, and its related companies, employees, representatives, agents, officers, and directors. This Waiver, Indemnity, and Release of Liability Agreement binds me and my heirs and personal representatives.
Voluntary.
I have read and voluntarily signed this Waiver, Indemnity, and Release of Liability Agreement. There have been no oral representations, inducements, or statements apart from this written Waiver, Indemnity, and Release of Liability Agreement.
I, the undersigned, hereby certify that the information given on this form is correct, that I am over the age of nineteen years, and I have read, understand, and agree to comply with the Waiver, Indemnity, and Release of Liability Agreement above.
I have read and fully understand and agree to the above terms of this Intake & Waiver Form. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability.
