I consent to treatment for myself and understand that the services provided by Ashlie Allen Inspired Living & Wellness, LLC are intended to enhance relaxation
and increase communication within my body.

I understand that these services are not a substitute for medical treatment or medications. I am aware that diagnosis is not given, and medication is not prescribed. I understand that participation is voluntary and that at any time I may choose to end my participation.

I understand that I may experience healing reactions or sensations during the 24 to 48 hours following the services provided.

I understand that any information exchanged during any session is educational in nature and is to be used at my own discretion. I also understand that any information imparted during these sessions is strictly confidential and will not be shared with anyone without my written
permission. I understand that by providing this informed consent I am assuming full
responsibility for my actions, and I, or my representative(s) agree to fully release and hold harmless the practitioner, Ashlie Allen and Ashlie Allen Inspired Living & Wellness, LLC from and against all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s), except in the case of gross negligence or malpractice.

I agree to the terms and conditions set out by this consent form and certify that the above information is true and correct.