Medical Consent

I am not experiencing any condition which would contra –indicate for present procedure. I accept that whilst every possible care will be taken for my well-being I am responsible for working to my own limitations to ensure that no injury occurs.

By signing below, I hereby certify that to the best of my knowledge all the information I have furnished on this form is complete, true and accurate. I have read the contents of this form / had the contents of this form read to me. I have been given the opportunity to ask the question and have them answered to my satisfaction. I am willing to be enrolled in the yoga/Hypnosis/ healing procedure.