Traditional & Non-Regulated Modality Disclosure
I acknowledge that Somatic Womb Touch is an integrative, body-based modality informed by various somatic, traditional, and experiential lineages. These practices are not yet part of regulated healthcare professions in Ontario and are not yet regulated or recognized as medical treatments by Canadian healthcare regulatory bodies. The service is offered for educational, self-exploration, and personal well-being purposes only.
Scope of Practice & Medical Disclaimer
I acknowledge and understand that Somatic Womb Touch is a non-medical, non-diagnostic, and non-therapeutic body-based modality intended to support embodiment, self-awareness, and personal well-being. This service is not a substitute for medical, psychological, psychiatric, gynecological, or other licensed healthcare services.
The practitioner does not diagnose, treat, cure, or prevent any medical or mental health condition; does not prescribe medications; and does not perform medical procedures or manipulations. Any information shared during sessions is educational in nature and is not medical advice. I understand that the practitioner may recommend consultation with a licensed healthcare professional when appropriate.
I confirm that I have disclosed all relevant health information, including but not limited to physical conditions, emotional or psychological considerations, pregnancy or postpartum status, medications, surgeries, trauma history, and any contraindications that may affect my participation. I agree to notify the practitioner promptly of any changes to my health status.
Assumption of Risk
I understand that Somatic Womb Touch involves physical contact and may evoke physical, emotional, psychological, or energetic responses. Potential risks may include, but are not limited to, temporary discomfort, emotional release, heightened sensation, fatigue, or unexpected emotional responses.
I voluntarily assume all risks associated with my participation, whether known or unknown, and acknowledge that individual experiences and outcomes vary. I understand that no specific results or benefits are guaranteed.
Participant Responsibility & Right to Withdraw
I acknowledge that my participation is entirely voluntary. I understand that I may decline any technique, modify my participation, request adjustments, or discontinue the session at any time without explanation or penalty. I accept full responsibility for communicating my boundaries, comfort levels, and needs throughout the session.
Release & Waiver of Liability
In consideration of being permitted to participate in Somatic Womb Touch, I hereby release, waive, discharge, and hold harmless the practitioner, their business entity, employees, contractors, agents, and representatives from any and all claims, demands, actions, damages, losses, or liabilities arising out of or related to my participation, including but not limited to bodily injury, emotional distress, or property loss, except in cases of gross negligence or willful misconduct.
This release is intended to be as broad and inclusive as permitted by law.
Confidentiality
I understand that all information shared during sessions will be kept confidential and will not be disclosed without my written consent, except as required by law.
Consent & Acknowledgment
I certify that I have read and fully understand this Informed Consent, Assumption of Risk, and Release of Liability. I acknowledge that I have had the opportunity to ask questions and receive satisfactory answers. By signing below, I voluntarily consent to receive Somatic Womb Touch and agree to all terms outlined above.