ANANDA WELLNESS
PRIVATE WELLNESS SESSION INFORMATION & WAIVER FORM

Thank you in advance for taking the time to complete this form. Please note that your information is confidential and will not be shared with anyone. Only in the case of an emergency will the necessary information be shared with your preferred Medical Practitioner named below. This information ensures your safety and supports a smooth, supportive and appropriate wellness session experience.

My Private Wellness Sessions may include:

  • TRE® (Tension, Stress & Trauma Release Exercises)
  • Post Surgery & Injury Recovery Support
  • Floor Yoga & Chair Yoga
  • Sound Healing
  • Energy Healing
  • Yin & Restorative Yoga
  • Prenatal Yoga
  • Breathwork
  • Meditation
Please note that certain wellness modalities may not be suitable for everyone depending on your current physical, emotional or medical condition.

TRE® PRIVATE SESSION IMPORTANT INFORMATION

TRE® (Tension & Trauma Release Exercises) may not be suitable for you at this time if:

  • You have an untreated major medical issue, broken bones, sprains or recent surgery still under physician’s care.
  • You are currently experiencing or struggling with bipolar disorder, schizophrenia, manic/depressive episodes, psychosis, severe untreated depression, borderline personality disorder or untreated PTSD.
  • Practicing alone with a qualified practitioner makes you feel unsafe.
  • The idea of having your body moved or physically guided feels overwhelming.
  • You are diagnosed with Epilepsy.
  • You are currently pregnant.

If any of the above applies to you, I will contact you privately to discuss whether another wellness modality may be more suitable for you at this time, or whether referral to a specialised TRE® provider may be recommended. Out of an abundance of caution, TRE® sessions will not be facilitated during pregnancy or for individuals diagnosed with Epilepsy.

CONFIDENTIALITY & CONSENT

Everything discussed within the time and space of our work together shall remain confidential and shall not be divulged to any third party by your Wellness Practitioner, unless in the case of a medical emergency. If participating in any group setting, no identifying information is to be shared outside of the group.

By saving and sending this form, you confirm that you undertake these sessions and practices of your own accord and accordingly indemnify the Wellness Practitioner from any harm, loss or damages of any nature, whether bodily harm, trauma or any other damages to your person or property resulting from the session, treatment or practices, whether directly or indirectly.

You understand and consent that these Private Wellness Sessions may include physical movement, assisted movement, breathwork, relaxation techniques, meditation practices, TRE®, restorative practices, sound healing, energy healing and/or physical hands-on support where appropriate.

You confirm that you have consulted with your medical practitioner where necessary prior to participating, and that you understand it is your responsibility to inform the practitioner of any physical, emotional or medical concerns prior to participation.

You further understand and agree that physical hands-on interventions (touch), props, soft balls, cushions, bolsters, blankets or other supportive tools may be used from time to time during sessions in order to assist and support the body and nervous system.

You confirm, understand and agree that the booked session may be ended at any time by the Wellness Practitioner should it be deemed unsafe or inappropriate for the session to continue.

Please note: No refunds, credits or rescheduling will be offered for sessions ended early by the practitioner, missed appointments, late arrivals, cancellations or rescheduling requests made by the client.

By law, we are required to collect this information.

Please take the time to also read Ananda Wellness Refund & Cancellation Policy.