Health Intake Form

By checking the box below, I the client, understand that Ancestral Healing Bodywork, (massage, Craniosacral Therapy, energy work, Cupping, Hot Stone, Manual Lymphatic Drainage), is for the purpose of stress reduction, relief from muscular tension, general relaxation and improvement of circulation The risks associated with massage therapy include, but are not limited to: superficial bruising, short-term muscle soreness, exacerbation of undiscovered injury.

Elena Aragon, Holistic Practitioner, does not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. A holistic treatment does not take the place of medical care. It is recommended that I see a licensed physician or licensed health care professional for any physical or psychological ailments client may have.

Client acknowledges holistic treatments can complement any medical or psychological care client may be receiving and will let the practitioner know about any changes to these. There may be additional risks based on my physical condition and it is the clients responsibility to communicate any discomfort client may feel during the treatment so adjustments are made accordingly.

Ancestral Healing can help unlock trauma stored in the body. This technique is an approach from Craniosacral Therapy working with the autonomic nervous system.

Client may experience:
- A sense of discomfort that can intensify temporarily that can lead to an emotional release, (crying, screaming, laughter)
- Memories from the past
- Physical release, (shaking, twitching, sweating)

Client understands he/she or Elena Aragon may terminate the session at any time and cannot guarantee healing the client does not guarantee results, for she can only assist the client in their healing process.

Client acknowledges that Ancestral Healing is a team effort, client will get out healing only as much as he/she puts into it. Client agrees to fully participate following the facilitators instructions to their best ability. Client agrees to communicate honestly, be open to feedback and assistance and to create the time and energy to participate fully in the program.

Client acknowledges he/she are solely responsible for creating and implementing their own decisions, choices, actions and results based on sessions and interactions with Elena Aragon. Client agrees that Elena Aragon is not and will not be liable or responsible for any action or inaction, or for any direct or indirect result of any services provided.

For the purposes of this agreement, "Confidential Information" includes all information disclosed by the Client to the Practitioner, whether in written, oral, or electronic form, that is not publicly known. This includes, but is not limited to, personal health information, private details of personal life, and any other information discussed during healing sessions.

Client gives consent and understands that sessions may be recorded for educational purposes, anonymity will be preserved. Before sharing any session recordings with a mentor, employees, assignees, or assessor, Elena Aragon will always ask for written consent pertaining to the restricted release of a particular session recording first and will also be accessible to.

All sessions are prepaid at the time of booking.

This policy is in place to honor and protect the time, energy, and dedication that goes into each healing session. Over the years, there have been last-minute cancellations, no-shows, and even clients who canceled payment after receiving their session. These situations directly impact my ability to serve others, create financial hardship, and leave valuable time slots unfilled.

To reserve a specific day and time, payment must be received at least 48 hours in advance. Appointments are not officially held until payment is received. If payment is not made within that time frame, the slot will remain open and may be booked by another client.

For this reason, all services must be paid in full when booked.

Clients may reschedule or cancel with at least 24 hours’ notice without penalty.

If you cancel with less than 24 hours' notice or do not show up to your appointment, the session is forfeited and a new appointment must be purchased. All sales are final.

This policy is not about punishment — it’s about mutual respect and honoring the healing work. Just as we wouldn’t skip a doctor’s appointment or therapy session without notice, this space is for those who are truly committed to their healing and growth.

Thank you for valuing this work and for showing up for yourself with the same care and integrity that is brought to each session.

Severability: The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. No Waiver: The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. Governing Law: This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of California. Notices: Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by email or certified/registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. Entire Agreement: This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. Modification of Agreement: Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. Assignment of Rights: The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. In this contract, any reference to a party includes that party's heirs, executors, administrators, successors, and assigns.