Please tick boxes to confirm you have read and understood*

I am aware the potential risks of the treatments are, Allergic Reactions, Skin, Irritation or Sensitivity, Temporary Discomfort or Pain, Bruising, Aggravation of Pre-existing Conditions, Dizziness or Lightheadedness, Emotional Release, Detoxication Symptoms, Interference with Medical Conditions or Medications, Risk of Infection.*

Tick to confirm you will let us know if you have any of the following prior to the therapy:

I, the undersigned, (name above) , have chosen to receive an Ayurvedic Treatment administered by Pete Fishlock, a member of the Indian Institute of Ayurvedic Yoga Massage (ARYM Institute), and The association of Ayurvedic Professionals UK (AAPUK)*

I understand that the Ayurvedic Massage treatment is not a substitute for conventional medical care.*

I understand that no specific result is guaranteed*

I understand that it is not a massage of a sexual nature. *

I am aware that this massage treatment may have side effects such as mild muscle soreness, bruising, occasional reactivation of painful areas, dizziness, deep relaxation, and emotional states (anger, excitement, awakening of past traumas, and repressed memories).*

I know that the therapist does not diagnose illnesses or injuries and does not prescribe medication.

*

I understand that the massage is performed on the skin and that there will be no stimulation or exposure of the genital organs and breasts during treatment.*

I understand that either the ayurvedic massage practitioner or I can terminate the session at anytime. *

I have provided a detailed medical history and I will inform the ayurvedic massage practitioner of any discomfort I may experience during the session, and I understand that the massage treatment will be adjusted accordingly.*

**The AYM & AM practitioner is committed to respecting the privacy of their clients. Any information that may be retained in the records will not be disclosed to a third party without the express consent of the client or as required by law.*

Client Acknowledgement:

I acknowledge that I have disclosed my health history and current health status above. I have disclosed all relevant health information and understand the importance of doing so for my safety and treatment effectiveness.*

I understand the nature of the treatments to be provided and accept the potential risks and benefits. *

I consent to receive treatments and understand that I can withdraw my consent at any time prior to and during my treatment but not after, and I understand that while Ayurvedic therapy can provide benefits, it is not a substitute for medical treatment from a licensed healthcare provider*

Disclaimer, please read the following disclaimer carefully before participating in any Ayurvedic treatments, massage, or Marma point therapy sessions provided by The Cure House Ayurvedic massage and Pete Fishlock.*

I understand the effectiveness of Ayurvedic therapy varies from individual to individual and cannot be guaranteed, I also understand that the Cure House Ayurvedic massage and Pete Fishlock does not accept liability for any injury or adverse effect that may arise from the use of our treatments.*

1. Nature of Ayurvedic Practices -The Ayurvedic therapies offered (including massage and Marma point therapy) are based on traditional Indian health practices and are provided as complementary therapies. They are not intended as a substitute for medical advice or treatment from a qualied healthcare provider. We do not claim to diagnose, treat, cure, or prevent any health condition.*

2. Informed Consent - All clients are required to provide informed consent by acknowledging their understanding and acceptance of the risks associated with the therapies provided. Participation is voluntary, and clients have the right to withdraw consent at any time, prior, during, but not after.*

3. Client Responsibility - Clients are responsible for providing a complete and accurate health history and for informing the practitioner of any health conditions, allergies, or medications that may affect their therapy. Failure to do so may result in adverse effects for which The Cure House Ayurvedic massage and Pete Fishlock cannot be held liable.*

4. Limitation of Liability - While we strive to provide beneficial and safe Ayurvedic therapies, the Cure House Ayurvedic massage and Pete Fishlock accept no liability for any injury, illness, or adverse effects occurring as a result of treatments received. This limitation of liability extends to any loss or damage, direct or consequential, arising out of the use of our services.*

5. Professional Indemnity - The Cure House Ayurvedic massage and Pete Fishlock maintain professional indemnity insurance appropriate to our practice. However, clients acknowledge that this does not guarantee a remedy for any claim.*

6. Complaints and Dispute Resolution - Any concerns or complaints regarding treatments received should be addressed directly to The Cure House Ayurvedic massage or Pete Fishlock in the first instance. We are committed to resolving disputes amicably and professionally.*

7. Governing Law - This disclaimer and any disputes arising from our Ayurvedic practices are governed by the laws of the United Kingdom, and any legal actions must be brought in the UK courts.*

Acknowledgment - By agreeing to receive Ayurvedic treatment from The Cure House Ayurvedic massage and Pete Fishlock, you acknowledge that you have read, understood, and agree to the terms of this disclaimer.

You accept that your participation is voluntary and at your own risk.*