Please read and fill out the form below:

It's very important to be sure your facilitator is educated and certified as situations may arise when extra support is required and, generally, to keep all participants comfortable and well. Your enjoyment and safety are top priorities!

I understand that the practitioner will be using gentle sound and vibration during the sessions on/around me. I understand that practitioners do not diagnose illness, disease, or physical or mental disorders, nor do they prescribe medical treatments or pharmaceuticals. I acknowledge that these sessions are not a substitute for medical examination or diagnosis, and that it is recommended I see a primary health care provider for those services.

I understand that if I am taking any medications or have any pre-existing medical conditions such as, but not being limited to:

• pace-makers

• metal in the body

• schizophrenia

• bi-polar disorder or psychosis

• epilepsy, heart conditions

• COPD

• delicate pregnancy

• high blood pressure or very low blood pressure with fainting history

• PTSD

• or recent major surgery

that I must advise the facilitator/s before the session.

I also understand that even though I have scheduled this session, I am responsible for any consequence (mental, physical or emotional) resulting from this Sound Bath session.

I understand and acknowledge that by participating in this session, I do so at my own risk. Since the session is experiential in nature and the extent of the session’s risks and benefits are not fully known, I agree to assume and accept full complete responsibility for any known and unknown risks associated with my participation in the session, including any physical injury, psychological or emotional effects

Michelle Prosek (Conscious Art Creation) is not a substitute for consulting your doctor or medical care provider. In the event of known medical conditions, I certify that I have consulted a health professional regarding any condition (physical, mental or emotional) that could interfere with my judgment, or affect my health in any way during or after the session.

I have read this waiver and signed the below confirmation that I take full responsibility for my own health and wellbeing.

Health Waiver