1. Consent for Services
By signing this form, I consent to receive the following services from Zhenya Alperovich, LMT, CYT, CWC, as part of the Sacred Womb Journey.
- Arvigo Techniques of Maya Abdominal Massage® (also known as Tul'ix Therapy)
A therapeutic practice rooted in the healing traditions of the ancient Maya people focusing on the abdomen and pelvis to encourage optimal organ function and overall vitality.
- Thai Massage
A traditional bodywork technique that integrates massage, stretching, acupressure, and gentle movement to restore mind-body wellness, relieve tension and restriction, and promote relaxation.
- Private Yoga & Somatic Practices
Personalized one-on-one sessions combining intentional movement, yoga postures, meditation, and/or breathwork to help you connect more lovingly with your body, process emotions, and cultivate presence.
- Self-Care Guidance
Customized wellness practices and self-care rituals based on Tul'ix Therapy and Zhenya Alperovich’s education and training, tailored to support you in nurturing body, mind, and spirit outside of sessions.
- Amethyst Biomat
During your massage, you will be lying on the Biomat, which combines the benefits of infrared heat, negative ions, and amethyst crystals. This facilitates deeper release, enhances receptivity, and supports your body’s natural healing process.
2. Contraindications
Biomat Contraindications
The Biomat is generally safe for most people but may be contraindicated in certain situations. Please consult with your healthcare provider before use if you have any of the following conditions:
- Pregnancy (particularly in the first trimester)
- Heat sensitivity or heat-related conditions (e.g., heat exhaustion)
- Active infections, fever, or acute inflammation
- Serious cardiovascular conditions (e.g., heart disease, pacemakers, uncontrolled hypertension)
- Active cancer
- Diabetes (especially with neuropathy)
- Multiple Sclerosis (MS)
- Blood clotting disorders (e.g., hemophilia)
- Impaired circulation or varicose veins
Maya Abdominal Massage Contraindications
Maya Abdominal Massage may not be appropriate for individuals with the following conditions. Please inform your practitioner if you have any of these conditions, as your session may need to be postponed, modified, or discussed with a healthcare provider:
- Pregnancy (first trimester)
- Recent abdominal surgery (within 6-8 weeks)
- Active abdominal infections or acute abdominal pain
- Severe varicose veins or abdominal hernias
- Very heavy menstrual bleeding (menorrhagia)
- Active cancer or tumors (especially in the abdominal or pelvic area)
- Blood clotting disorders or poor circulation
- Pelvic Inflammatory Disease or endometriosis (during flare-ups)
- Recent miscarriage or abortion (within 6 weeks)
- Severe digestive conditions (e.g., Crohn's, ulcerative colitis)
3. Acknowledgment of Treatment Limitations
I understand and acknowledge that each of these offerings is intended to support my overall well-being and are not intended to replace medical care.
- The practitioner does not diagnose, treat, or cure medical conditions, nor prescribe herbs or medications.
- If I have any medical concerns, I agree to consult with a qualified healthcare provider and keep my practitioner informed of any changes in my health.
- These services are not intended to replace psychotherapy or directly address trauma. While emotional exploration may arise, my practitioner does not provide trauma therapy.
- If psychotherapy or additional mental health support is needed, I will be referred to trusted professionals.
4. Confidentiality of Health Information
I understand that all personal and health information I share will be kept confidential in accordance with HIPAA regulations.
- I consent to my practitioner keeping notes on my health history and treatment plan for the purpose of providing appropriate care.
- Any shared information will only be used for certification or statistical purposes by Tul’ix Indigenous Arts (formerly the Arvigo Institute), and no identifying details will be disclosed without my permission.
5. Acknowledgment of Risks
I understand that there are inherent risks involved in receiving physical treatments, including massage and yoga.
- If I experience any discomfort, pain, or unusual symptoms during or after a session, I will notify my practitioner immediately.
- I am free to stop or modify the treatment at any time.
6. Liability Waiver
By signing this form, I release Zhenya Alperovich from all liability for any injury, discomfort, or other claims arising from my participation in these services, including both known and unknown risks associated with massage, yoga, and self-care guidance.
- I acknowledge that I am responsible for my own well-being and will provide accurate health information to help ensure the treatments are safe and effective.
7. Client Consent & Acknowledgment
I consent to receive the services described above and acknowledge that I have read, understood, and agreed to the terms of this form. I understand that I may modify or discontinue treatment at any time, and I am free to ask questions as needed.