• Format: (000) 000-0000.
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  • The Covid-19 vaccinations: please note: Linked adverse health events include: Breathing difficulties, Tightness in the Chest/Chest pain, Heart rhythm/rate disruption, Heart Attack, Blood Clotting Disorders. Shingles, Nerve damage, Lower limb pain, Headache, Dizziness, Skin eruptions, Muscle weakness and Fatigue.

  • Please leave at least two weeks from taking any Covid-19 injection and your Structural Integration session.

    Adverse reactions to the Covid-19 'vaccine' in UK can be checked here:

    https://yellowcard.ukcolumn.org/yellow-card-reports

  • APPLICATION AND CONSENT FOR STRUCTURAL INTEGRATION

    fully I hereby apply for a series of Structural Integration sessions. I understand the purpose of Structural Integration is to balance and align the physical body so that it is supported and maintained by gravity in three- dimensional space. This is done through direct manipulation and education so that greater economy and freedom of body-movement is achieved. I understand Structural Integration is not involved with the treatment of disease of any kind, nor does it substitute for medical diagnosis or treatment when such attention is needed. The practitioner of Structural Integration does not treat, prescribe or diagnose an illness, disease, or any other physical or mental disorder of the person. Nothing said or done by the Structural Integration Practitioner should be misconstrued to be such. Iunderstand it is necessary for the Structural Integration practitioner to touch my body in order to assist me in establishing balance and alignment in my body. I therefore give my practitioner permission and consent to work on my body in such a way as to restore and establish balance and alignment therein. Any relief of physical or emotional symptoms is coincidental in the organisation of the total human being and is not the basic goal of Structural Integration. Furthermore, I understand that, if I have received any Covid-19 'vaccination' and I develop any symptoms consistent with the associated side effects, I acknowledge that these are not related in any way to the Structural Integration bodywork.

  • Clear
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  • Client copy; please retain for your files

  • APPLICATION AND CONSENT FOR STRUCTURAL INTEGRATION

  • I hereby apply for a series of Structural Integration sessions. I fully understand the purpose of Structural Integration is to balance and align the physical body so that it is supported and maintained by gravity in three- dimensional space. This is done through direct manipulation and education so that greater economy and freedom of body-movement is achieved. I understand Structural Integration is not involved with the treatment of disease of any kind, nor does it substitute for medical diagnosis or treatment when such attention is needed. The practitioner of Structural Integration does not treat, prescribe or diagnose an illness, disease, or any other physical or mental disorder of the person. Nothing said or done by the Structural Integration Practitioner should be misconstrued to be such. Iunderstand it is necessary for the Structural Integration practitioner to touch my body in order to assist me in establishing balance and alignment in my body. I therefore give my practitioner permission and consent to work on my body in such a way as to restore and establish balance and alignment therein. Any relief of physical or emotional symptoms is coincidental in the organisation of the total human being and is not the basic goal of Structural Integration. Furthermore, I understand that, if I have received any Covid-19 'vaccination' and I develop any symptoms consistent with the associated side effects, I acknowledge that these are not related in any way to the Structural Integration bodywork.

  • Clear
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