Please take a moment to read the following information:

• I understand that services provided by Grounded Balance LLC are provided for stress reduction, relaxation, relief from muscular tension, improvement of circulation and energy flow, and improvement of one’s overall quality of life.

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• I understand that I am responsible to be cleared by my medical provider before participating in any exercise program.

• I understand that by participating in any therapeutic exercise or stretching program there are risks that could include strained or pulled muscles, exacerbation of pain symptoms or fatigue depending on participant physical condition, knowing these possible risks, I release my practitioner from any of the above

• I understand that comfortable clothing is recommended and that if I am feeling any discomfort at any time during any service provided, that I am to notify my practitioner immediately.

• I understand that all information shared between client and practitioner will remain confidential.

• I understand that the services offered by Grounded Balance LLC (Reiki, Therapeutic Exercise/Stretching, Meditation and participation in Group

• (Events) are not a substitute for medical care. I understand that my practitioner is not qualified to diagnose physical or mental illness.

• I affirm that I have notified the practitioner of all known medical conditions and injuries.

• I agree to inform the practitioner of any changes in my health and medical condition. I understand that there shall be no liability on the practitioner’s part should I forget to do so.

• I understand that if I cancel within less than 24 hours or "no show" that there may be a charge for the cost of the missed appointment or service I have scheduled.

• I hereby waive and release the practitioner of any and all liability, past, present, and future relating to the services provided or activities I participate in with Grounded Balance LLC.