Aaiyyanist treatment consent form

(Use this template for any new clients)

Clients name: __________________________________________________________________

Please read the following conditions before signing.

• I have been advised by the Aaiyyanist Healer that if I suspect I may have a medical (physical or psychological) condition, I must seek help from a recognised qualified medical professional. Aaiyyanist practitioners do not diagnose medical conditions, nor do they prescribe or perform medical treatments. Aaiyyanist Healers do not prescribe pharmaceutical medicines (unless they are qualified to do so), and should not interfere with any treatment from a licensed medical professional.
• I declare that I am over the age of 21. I also understand that those under the age of consent (21 and under) require their parents or guardians to attend all sessions and to sign this form. Aaiyyanism is extremely powerful and should be used with care when dealing with young patients.
• I do not suffer from any contagious/infectious diseases, which could spread to other clients or Healers. And I am not under the influence of any drugs or alcohol during my healing/Siddhi session that may impact on my spiritual state of mind.
• I confirm that all the details given by me to the Aaiyyanist Practitioner are factually correct. I also confirm that if any of the personal information I have freely given changes, then I will inform the Aaiyyanist practitioner as soon as possible. The information I have given is correct to the best of my knowledge and I have not withheld any relevant information concerning my treatment. Privacy is paramount and I understand that all the information I have given will be treated in the strictest of confidence.
• The Aaiyyanist Practitioner has fully explained the detailed treatment and the procedures involved, and I understand that Aaiyyanism is a gentle, ancient resonant hands-on energy healing technique that can complement any medical/psychological care I may be receiving. I understand that at all times the privacy of my personal body/space will be maintained and I am not required to remove any clothing.
• I have had the opportunity to ask questions regarding the Aaiyyanist Healing/Siddhi methodologies and I am willing to proceed with an Aaiyyanist Treatment. I undergo this Aaiyyanist Treatment entirely at my own risk and understand that the Aaiyyanist Practitioner accepts no liability for loss or injury resulting from this treatment, and I must communicate any levels of discomfort (both physical, mental and spiritual) during the session.

 I understand that the fee per Aaiyyanist Treatment is: ____________________________________________  

 Signed (Client):              _____________________________________________________________________ 

 Print Name (Client):          _____________________________________________________________________ 

 Signed (Practitioner):        _____________________________________________________________________ 

 Print Name (Practitioner):    _____________________________________________________________________ 

 Date:                         _____________________________________________________________________