The Sound Healing Academy's professional code stresses the importance of accurate and up to date client information. All information provided will remain strictly private, confidential and in accordance with Data Protection.

Please complete all information below:

Are you pregnant or trying to be pregnant?

YES / NO (if yes please give details)

Do you have any metal medical implants

YES / NO (if yes please give details)

Do you have a deep vein thrombosis in the leg or known thrombi?

YES / NO (if yes please give details)

YES / NO (if yes please give details)

Do you have any acute inflammations and tumors?

YES / NO (if yes please give details)

Have you recently had any surgery?

YES / NO (if yes please give details)

Do you have carotid atherosclerosis?

YES / NO (if yes please give details)

YES / NO (if yes please give details)

Do you have any inflammatory skin disorders?

YES / NO (if yes please give details)

Do you have any other inflammatory processes generally associated with fever? Do you have a cardiac pacemaker, artificial heart valves, defibrillator or cardiac arrhythmias Do you have a shunt?

YES / NO (if yes please give details)

YES / NO (if yes please give details)

Do you have a deep brain stimulation device

YES / NO (if yes please give details)

Have you had whiplash in the last 3 days?

YES / NO (if yes please give details)

Have you received the Covid and Flu Shot?

YES/NO (If yes please give approximately dates)

I understand that the sound healing therapy sessions offered by the Golden Rose Galaxy professional Sound healing practitioner (specialized in the Autonomic Nervous system (ANS) involve natural and non-invasive methods of energy balance, sound healing instruments application, movement and toning exercises.

I understand the above statement in regards to services offered and give permission to Anne to perform sound healing sessions and suggest exercises and I have disclosed any information (health or otherwise) that might alter the effectiveness of the services offered.

I understand that if at any time I feel discomfort or have a problem with the session, it is my responsibility to voice my concerns.

I understand that a deposit of 50% (or full payment when on offer) is required to secure my booking and that the remainder of the full payment is required at the time of services offered.

I must give 24 hours' notice for cancellation to avoid loss of deposit. For cancellations made more than 24 hours in advance, my deposit can be transferred to another session up to two months after the original session date. I understand that at any time during the session I can request to stop the session, though this may not entitle me to a refund. By signing below, I acknowledge and fully agree with all the above information.

If you follow these guidelines, the sound healing process will have a deeper and longer lasting effect.

Following the sound healing group session it's best to take it easy, rest, relax, go for a walk and avoid stressful situations. When you get home have a bath or a shower as the water will allow the sounds to sink in deeper and last for longer.

Please avoid red meat, alcohol or any chemical toxins for the next 24 hours Please drink plenty of water to not only keep you hydrated but also to allow any toxins released by the sound healing to be flushed from the body.

There are no officially recognized side effects of sound healing. Sometimes complementary therapy can cause a healing reaction. During or after the sound healing session, you may experience a worsening of symptoms before they get better.

In the unlikely event that a healing reaction does happen, you can contact me to discuss this matter. If you feel the situation needs closer attention you should contact your doctor / physician. If you feel you need immediate medical care, you should not hesitate to contact a medical professional.

 

For further information, please contact:

Practitioner: Anne Spínola Tel: 07793058882 Email: thegoldenrosegalaxy@hotmail.com Web: www.thegoldenrosegalaxy.co.uk