Contract for Services

About Holistic Therapy
Holistic Therapies are noninvasive complementary modalities provided through natural processes. Therapies are intended to help the body systems to relax and achieve a more balanced state which supports the body to function optimally. Additional general information about specific modalities offered and what to expect are available at aim2ease.com. Participants are encouraged to seek further information from multiple sources and to resolve concerns. Participant is solely responsible for their decision regarding participation and own health care.
Potential impact of therapies
Shifts in biochemical and physiological status of the body.
Shift in nervous system to reduce tension and stress and provide relaxation.
Improve movement in energy systems in and around the body.
Promote balance and normalization of the body which supports natural self-healing.
Stimulate circulation resulting in delivery of oxygen and nutrients to cells.
Physical, mental, and/or emotional shifts vary and may be immediate, cumulative, or up to months later.
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Holistic Therapies are not a substitute for medical care; practitioner
does not diagnose, treat, or prescribe medication for any specific condition or illness.
recommends consulting a physician or other qualified medical specialist for specific symptoms/conditions.
may deny services if there are contraindications and/or request medical clearance.
has no liability for not being updated of changes to physical, mental or emotional health.
Privacy and Service Provision
Personal information, given at intake and all subsequent communications, is taken to obtain general health information and used for personalized provision of services. Personal information will be safeguarded and not be disclosed without written consent. You are welcome to ask questions and/or provide feedback. Practitioner is not liable for problems that you perceive as attributed to therapies. There are no guarantees as to reactions or results. Practitioner may terminate or refuse services for behavior deemed inappropriate or in violation of policies. Full payment will still be due.
Cancellation, Reschedule & Late Policy
Remembering your appointment is your responsibility; no reminders are not sent prior to scheduled session. If you arrive late, session will be adjusted to end at original scheduled time. Via text or email, you may cancel your appointment at least 48 hours in advance or reschedule at least 24 hours in advance with no fee. Less than required notice of appointment change, FOR ANY REASON will result in an invoice/bill as follows:
Cancel less than 48 hours- full regular session rate
Reschedule less than 24 hours– full regular session rate
If you are unable to keep your appointment under the 48 hour notice, you have the option to send an alternate person at your scheduled time. Notice must be given at time of cancellation; you are still responsible for the appointment fee until your replacement arrives/pays, pre-pays, or puts a credit card on file, whichever comes first.
If you do not pay the outstanding balance within 24 hours of receipt, future appointments will not be confirmed until invoice is paid; future appointments are subject to pre-payment or a credit card on file.
Informed Consent
I freely elect to receive the therapies selected. I have provided accurate intake information and will update practitioner of change in status. By signing this form, I acknowledge acceptance of information and policies provided.
Signature: ___________________________________________________Date________________________
Print Name__________________________________________________