AGREEMENT:
I understand that all information I entered in this form will be considered strictly confidential. The data gathered from this form will only be used as a basis to discern the needs and intentions of our session(s) together.
Phillida and Jesse are Teachers and Facilitators of applied Yoga, Tantra and Ayurveda. Yoga, Tantra and Ayurveda are not substitutes for medical attention, examination, diagnosis, or treatment. The methods of Yoga, Tantra and Ayurveda are not recommended under certain medical conditions. I confirm that I have been truthful and complete in my entries to the above assessment form, so to establish my true individual needs and health status. Neither Phillida or Jesse are medical professionals and as such I understand that it is my responsibility to consult with a physician prior to and regarding the nature of my participation in any sessions with Phillida or Jesse. I agree that I am able to participate and have no medical condition which would prevent my participation.
Thank you.
Yours in health,
Shava Yoga.