Vibrational Balance Waiver Form
  • Format: (000) 000-0000.
  • Vibrational Balance Client Waiver, Informed Consent & Release of Liability


    Please read carefully before signing. Participation in any Vibrational Balance session indicates your acceptance of this agreement.


    1. Description of Services
    I understand that services provided by Erica Gunter at Vibrational Balance may include, but are not limited to:

    Energy healing modalities such as the Emotion Code, Body Code, Belief Code, chakra balancing, vibrational alignment, and intuitive guidance
    Use of the Bio-Well device, which captures electro-photonic emissions (gas discharge visualization) from the fingertips to assess energetic and physiological states
    I acknowledge that these services are complementary support for my overall well-being and are not a substitute for medical, psychological, or psychiatric care. They do not diagnose, prescribe, or treat any medical condition.

    I affirm that:

    I will continue to follow the guidance of my licensed healthcare provider(s)
    I will not discontinue medications, therapies, or appointments based on information received during sessions
    I am fully responsible for my own physical and mental health care decisions

    2. Bio-Well Device Disclaimer & Consent
    I acknowledge that:

    The Bio-Well is a wellness assessment tool designed to offer insights into energetic balance, stress levels, chakra alignment, and energy reserves
    Bio-Well readings are non-invasive, safe, and for personal awareness only
    The Bio-Well does not diagnose, treat, or cure any condition and should not replace conventional medical care
    I consent to the use of Bio-Well for my sessions and understand that the results are for my holistic development and self-awareness

    GDPR Consent for Bio-Well Data (for EU Clients and Global Compliance)
    In accordance with the General Data Protection Regulation (GDPR) and similar global privacy standards, I give explicit consent for Vibrational Balance to collect, store, and process my biometric data gathered via the Bio-Well device.
    I understand that:
    My biometric data (e.g., fingertip scan results) will be securely stored for wellness tracking and session notes.
    I may request to view, amend, or delete this data at any time.
    My data will not be sold, transferred, or shared with third parties.
    I can withdraw my consent at any time by contacting Erica Gunter via email at erica@vibrationalbalance.com
    Data will be stored for no longer than is necessary and will be safely deleted upon request or after the agreed retention period.

    3. Personal Responsibility & Assumption of Risk
    I voluntarily assume all risks associated with participation in sessions, whether in-studio, in-home, or remote, including physical, emotional, or psychological effects. I understand that results may vary and are not guaranteed.

    I accept full responsibility for my own well-being during and after sessions, and I will communicate any discomfort, concerns, or questions immediately.


    4. Confidentiality
    All personal information and session-related data, including Bio-Well results, will remain strictly confidential and will not be shared without my written consent, except as required by law.


    5. Release of Liability & Indemnification
    I hereby release, waive, and discharge Erica Gunter, Vibrational Balance, and affiliated staff from any and all liability, claims, or demands arising from my participation in any sessions or use of the Bio-Well device.

    I agree to indemnify and hold harmless Vibrational Balance and its representatives from all claims, costs, damages, or expenses (including attorneys’ fees) arising from my participation or from claims brought by third parties related to my session(s).


    6. Florida Law & Jurisdiction
    This waiver shall be governed by the laws of the State of Florida. Any disputes arising from this agreement shall be resolved in a court of competent jurisdiction in Collier County, Florida.


    7. Severability
    If any part of this waiver is found to be invalid or unenforceable, the remainder shall remain in full effect.


    8. SMS & Communication Consent
    By providing my phone number, I consent to receive SMS messages from Vibrational Balance for appointment confirmations, reminders, and important updates. I may opt out at any time by replying STOP or contacting erica@vibrationalbalance.com.


    9. Consent & Agreement
    I confirm that I have read this document in full, understand the services offered, their limitations, and the risks involved. I affirm that I am at least 18 years old, or have a legal guardian sign on my behalf.

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