HEALTH AND SAFETY, WAIVER AND RELEASE FORM

SOMATIC PERSONAL RESONANCE EDUCATION

I hereby voluntarily request to receive services from Joy Walker, SPRe® Practitioner. I consent and understand that these services may include physical touch. I acknowledge that no guarantees have been made to me as to the effect of such care.

I further acknowledge that the above service is not meant to be construed by me as the diagnosis or treatment of disease, but rather as an aid to balancing my general wellness. Therefore, in consideration for my participation in SPRe®, I personally and on behalf of anyone competent to make claims on my behalf, waive any and all claims and assume all risk of loss, damage or injury associated with or incurred during my participation with my SPRe® Practitioner.

I recognize that I am responsible for my health and well-being, and that it is my duty to myself to be an informed partner in the care I receive. To this end, I will secure the self-knowledge that I need in order to fully work with my SPRe® Practitioner.

I confirm that my physical condition allows me to participate in SPRe®, if I have any question about my physical condition in this regard, I will seek a physician’s advice.

Regarding remote sessions specifically: By clicking on the link included in your email or accepting the phone call from your SPRe® Practitioner, you agree that you are aware that you are engaging in a somatic and physical activity. We will be using verbal attunement and other SPRe® skills to help support your own effective action. You are responsible for your own body and what you decide to do. You release SPRe®, Studio Evolve, Inc. for any responsibility if you injure yourself while participating in these livestream sessions. You agree that you are participating voluntarily in these sessions and assume all risk for participation. Please provide us with the address of the physical location where you will be taking the call and the name and number of an emergency contact, in case of an emergency.

Additional COVID-19 Considerations:

• Your Practitioner will greet you at the door at the time of your session. Text your Practitioner when you have arrived at the studio.

• Masks are required at all times when inside Studio Evolve. Masks are provided if you don’t bring your own.

• Our water dispenser is not available, please bring your own water if needed.

• The single toilet bathroom will be available and wiped down between each session. Disinfecting wipes are provided if you want to clean surfaces yourself.

• Your Practitioner will clean surfaces in their room as well as studio door handles in between sessions.

• On the bodywork table, we have a vinyl cover on the pillow if needed. The table pad is also covered in vinyl. The sheets for your session will be used to cover each side of your body. This will protect our clothing, both client and practitioner.

• The client sofa/chair will have a protective cover that will be sprayed with a disinfecting solution between sessions.

• Please cancel your appointment and stay home if you feel any symptoms of COVID-19 as listed by the CDC: fever or chills, cough, shortness of breath/difficulty in breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea. Your Practitioner will follow the same guidelines regarding symptoms.

I have read and understand the foregoing and voluntarily sign this Waver and Release Form.

Payment & Cancellation Policy

I understand that payment by cash, check, Venmo or Zelle is due at the time of service. I understand that 48 hours notice of cancellation is required. There is no charge for cancellations received with more than 48 hour notice. For cancellations without notice or with less than 48 hours notice, a full session fee is charged.