I, the undersigned, understand that this consultation is not a substitute for medical attention, examination, diagnosis or treatment and may not recommended and or considered safe under certain medical conditions. I should consult a physician prior to beginning any wellness program. I recognize that it is my responsibility to notify
Balance 2 Heal of pregnancy, any serious illness, and/or injury before proceeding. I affirm that I alone am responsible to decide on my wellness. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against
Balance 2 Heal or
Eliza Alys Young. Those under 18 years of age must have this form signed by a parent or guardian.
I confirm that I have read and agree to the
Terms & Conditions.