Disclaimer By filling out my first and last name below, I give consent for this healing session. I understand fully that the content from the session is not given by a medical professional and does not diagnose or replace the advice of my physician. I understand that during this holistic healing session with Rebecka Wozniak I will receive insights + information for the purpose of relaxation, relief and reclamation of my body, mind and spirit. I further understand that this holistic approach should not be construed as a substitute for medical examination, diagnosis or treatment and that I should see a qualified medical specialist in regards to such inquiry. I understand that energy medicine practitioners are not qualified to diagnose or prescribe western medications. I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the therapist updated as to any changes in my medical profile and understand that there shall be no liability on the therapist's part should I fail to do so. I understand that when I purchase a six month healing bundle I must complete the sessions in the agreed upon timeline and if I fail to do so all unused sessions will be null and void. I agree to give 7 days notice if I choose to reschedule or cancel an appointment for any reason other than a family emergency or sudden illness. If I do not follow the cancellation guidelines as above or do not show up to my appointment at the agreed upon time, I agree to pay the full cost of the healing session. By submitting this form I affirm the accuracy of the information I have provided and understand and agree to the policies above. * Thank you!