Tuning Fork Therapy Waiver

I understand that Tuning Fork Therapy is a complementary practice that may help to relieve pain, to process emotions, and to relax and regulate the mind.  Every person’s response to sound and frequency is unique.  In rare instances, some individuals may temporarily experience negative feelings or memories or uncomfortable physical sensations. There is no guarantee, expressed or implied, that this therapy will cure any condition or disease. *Please discuss use of Tuning Forkswith your healthcare provider before use to decide if it is right for you.

I also understand that if I have:  very low blood pressure, an active bleeding disorder or thrombus (blood clot), angina (chest pain), a pacemaker or other metal implants, active or acute inflammation, a prolapsed intervertebral disc, whiplash, head injury, internal or external bleeding (menstrual bleeding does not apply), recent surgery, am or could be pregnant, psychotic, pre-psychotic or border-line psychotic conditions or severe neurotic conditions, recent myocardial infarction (heart attack) or have post-traumatic-stress disorder there could be a risk for an adverse reaction from sound and frequency work with tuning forks. It is possible that people with diabetes will experience insulin "feeling" during or shortly after therapy sessions. Tuning Forks are NOT a treatment for diabetes and have no positive effect on diabetes. 

I have approval from my healthcare provider and have had the opportunity to discuss my history of any of the aforementioned disorders with the vibroacoustic therapist prior to receiving atuning fork session. I hereby consent to and authorize vibroacoustic therapy using tuning forks.