Client Disclosure and Informed Consent
To be reviewed when booking your session/class.
I hereby attest to the following:
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I fully understand that Emanda Thomas of MaRen Ayurveda is not a licensed medical doctor, does not diagnose or treat disease, and that I am not here for medical, diagnostic or treatment procedures.
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I fully understand that Emanda is certified as an Ayurvedic Health Counselor, trained by the California College of Ayurveda.
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I fully understand that Ayurveda is a complementary and alternative health care system and that her services may be utilized as a complement to my current health care program.
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I fully understand that if, as a result of the intake examination any findings suggestive of a possible medical imbalance is found, Emanda Thomas will refer me to a Medical Doctor for further evaluation.
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The services performed by Emanda Thomas, whether in person, over the internet, or by mail or phone, are at all times restricted to consultation on the subject of wellness and health assessment. These services are solely intended to provide me with resources to use to promote my own health and well-being. Her services do not involve diagnosing, treatment, or prescription of remedies for the treatment of disease.
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I fully understand that it is my constitutional right to decide how I wish to care for my health. Emanda Thomas has not suggested that I cease current medical care I am receiving, be it drug therapy, x-ray treatments, chemotherapy, surgery, or any other medical procedures that my medical doctor or any other health practitioner deems necessary for my health. If I choose not to follow the recommendations made by my medical doctor or other practitioners, I understand that such a decision is my responsibility and will not hold any other persons responsible for any consequences of such a decision.
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I choose to meet with Emanda Thomas, for health and wellness support, solely on my own behalf.
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I am not an agent from a federal, state or local government agency on a mission of entrapment or investigation.
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I understand that all information discussed will be kept strictly confidential.
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I understand that this information is linked to the booking page and that booking a session demonstrates my consent.