STEP 2
Mental ConsTITUTION Evaluation
Please complete the form carefully considering each option with honesty. Try to answer all questions even if they seem repetitive. If you are unsure of how to answer, it may help to ask someone who knows you well.
STEP 3
AMA / NUTRITIONAL ANALYSIS
Please complete the questionnaire below to the best of your ability and according to your present condition for the most accurate analysis.
Don’t forget to sign the Liability Waiver.
Thank you for completing your Ayurvedic assessment.
This assessment does not diagnose any heath conditions nor does it provide medical advice. Consult with a healthcare professional before making any major lifestyle changes or if you have concerns about your results.
WAIVER OF LIABILITY
I hereby agree to the following:
1. I am participating in classes or services during which I will receive information and instruction about yoga and health. I recognize that yoga and related practices require physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated.
2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical fitness program, including yoga. I represent and warrant that I have no medical condition that would prevent my participation in physical fitness activities. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the teacher or instructor. I will continue to breathe smoothly.
3. In consideration of being permitted to participate in the yoga or related classes and services, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in the program.
4. In further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily, and expressly waive any claim I may have against the instructor, the owner, or the leaseholder of the building for injuries or damages that I may sustain as a result of participating in classes, services or workshops held with Daily Ritual, LLC.
5. That if I participate in other classes, services or events with Daily Ritual, LLC (such as forms of movement, martial arts, energy healing, etc.) that I will also assume full responsibility for any injuries that may result from my participation, with the same considerations that this waiver stipulates for yoga (items 1-4 above).
6. I understand that reiki is an energetic healing methodology, which involves “laying on of hands” to heal. I understand that I will be fully clothed during the session and experience a series of “safe touch” hand positions on and above my body. I also understand that reiki and energy healing services are provided for relaxation and stress reduction. Practitioners do not diagnose conditions, nor do they prescribe substances or perform medical treatment, nor interfere with treatment of a licensed medical professional. Reiki sessions are provided separately from and to complement medical services. I affirm that I have disclosed all known medical conditions, any ailments, and current prescription medications. I agree that, prior to any session, I shall inform my practitioner of any changes in these conditions.
7. I have reviewed terms and conditions and know that I must give 24 hours notice if I cannot keep a future appointment. I understand that information exchanged during a session is educational in nature and is intended to help me become more familiar and conscious of my own health status and is to be used at my own discretion. I understand that all communication between the practitioner and myself, verbal/written, shall be kept confidential.
8. Yoga and related practices are not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in such a fitness program. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Daily Ritual, LLC and associated service providers.