Wellness Services Informed Consent & Assumption of Risk
Insights Wellness Center, LLC offers a variety of wellness, educational, spiritual, and mind-body services. Depending upon the service selected, offerings may include Reiki, yoga therapy, spiritual counseling, psychoeducational or psychospiritual consultation, wellness programs and groups, retreats, and related mind-body practices.
Services may take place at Insights Wellness Center, at another location, outdoors, or virtually. This form is intended to support informed and voluntary participation in these services.
Psychotherapy and other licensed clinical mental health services are also governed by the separate informed-consent, privacy, and practice policies of Insights Wellness Center, LLC.
Health & Participation
Participants are responsible for informing the practitioner of any medical condition, illness, injury, physical limitation, pregnancy, medication effect, or other circumstance that may reasonably affect safe participation.
Participants are encouraged to consult an appropriate healthcare professional before beginning a physical or mind-body activity when there are questions or concerns about their ability to participate safely.
Informed Participation
I understand that some wellness services may involve physical movement, stretching, breathing exercises, relaxation practices, meditation, emotional exploration, energy-based practices, or other experiential activities.
I understand that participation may involve inherent risks, including physical discomfort, muscle soreness, strain, dizziness, emotional discomfort, or other unexpected responses.
I agree to listen to my body and exercise my own judgment regarding participation. I understand that I may decline, modify, pause, or discontinue any activity at any time.
Assumption of Inherent Risk
By choosing to participate, I acknowledge and voluntarily accept the ordinary and inherent risks reasonably associated with the wellness activity or service in which I participate.
I understand that results from wellness, spiritual, educational, and mind-body practices vary from person to person and that no specific outcome or result can be guaranteed.
When participating virtually or away from Insights Wellness Center, I understand that I am responsible for choosing an appropriate and reasonably safe environment in which to participate.
Participant Responsibility
I agree to participate only to the degree that feels safe and appropriate for me, ask questions when I do not understand an activity or instruction, and promptly inform the practitioner of pain, dizziness, emotional distress, or another concerning response.
I understand that wellness services are not a substitute for medical evaluation or treatment and that I should seek appropriate medical or emergency care when needed.
Minors
If I am signing on behalf of a minor participant, I certify that I am the minor’s parent or legal guardian and have authority to provide consent for participation.
Acknowledgment & Consent
By signing below, I acknowledge that I have read and understand this agreement, have had an opportunity to ask questions, and voluntarily choose to participate in appropriate wellness services offered by Insights Wellness Center, LLC.
I understand and accept the inherent risks reasonably associated with the activities I choose to participate in.
Typing my name electronically and submitting this form serves as my electronic signature and acknowledgment of this agreement.
