Sound Session Consent, Liability Release & Privacy Acknowledgment
I hereby consent to receive a sound-based relaxation session, which may include the use of gentle vibration, sound bowls, chimes, tuning instruments, voice guidance, meditation, and other sound-based wellness tools used on, near, or around my body.
I understand that the practitioner may use gentle sound and vibration during the session to support relaxation, rest, and self-care. I understand that I remain fully clothed during the session unless otherwise stated, and that I may ask the practitioner to stop or adjust the session at any time.
I acknowledge that this session is not a medical service and is not intended to diagnose, treat, cure, or prevent any disease, condition, injury, mental health concern, or medical issue. I understand that sound sessions are not a substitute for medical care, medical examination, mental health counseling, diagnosis, or treatment from a licensed healthcare provider.
I confirm that I have completed this form to the best of my ability and have disclosed any relevant health concerns, sensitivities, pregnancy, implanted medical devices, hearing sensitivities, recent surgeries, seizure history, or other conditions that may affect my participation. I understand that it is my responsibility to consult with my physician or qualified healthcare provider before participating if I have any concerns.
I understand that participation is voluntary and that I assume responsibility for my own comfort, safety, and well-being during and after the session. I release the practitioner, host location, ASE Collective, Valhar Health Solutions, and any affiliated staff, volunteers, or representatives from liability for any discomfort, reaction, injury, loss, or damages that may arise from my voluntary participation, except where prohibited by law.
Privacy Acknowledgment
I understand that any personal information shared on this form will be used only for session preparation, communication, safety awareness, and administrative purposes related to this sound experience. My information will be kept private and will not be sold or shared publicly. I understand that this form is not a medical record and does not establish a medical provider-patient relationship.
By signing below, I acknowledge that I have read, understood, and voluntarily agree to participate in this sound-based relaxation session.