Purchases are non-refundable.

Roots to Branches Whole Health Clinic warmly welcomes you to our yoga classes. As everyone comes to yoga for different reasons please always let your teacher know of any injuries or relevant medical information, especially if you are new, if your situation has changed, or if you have a new teacher.

The golden rule is ‘if it does not feel right then do not do it’. We encourage you to stop whenever you need to. Feel free to ask for assistance if you are unsure about whether a pose, movement or breathing/meditation instruction is right for you. We are here to help you get the most from your practice and are happy to offer adjustments or alternatives.

Waiver of Liability: I understand that yoga, breath work & meditation include physical movement as well as an opportunity for relaxation, and stress management. As is the case with any activity such as these, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will cease or adjust the posture or technique and ask for support from the teacher. Yoga, breathwork & meditation are not substitutes for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible for deciding whether to practice yoga, breathwork & meditation. If my health condition should change I agree to fill out a new Waiver of Liability form and advise the yoga instructor. I am not pregnant. I hereby agree to irrevocably release and waive any claims that I have now or hereafter against Tracy Palmer Naturopathic Doctor Inc O/A Roots to Branches Whole Health Clinic and its authorized instructors.

By clicking the box you confirm that you have read the above, and understand the risks associated with yoga and meditation practice.

Cupping Consent

Please Read Carefully and Consent Below

About Cupping:

Cupping is a therapy that applies negative pressure on the skin using glass, plastic, or silicone cups. The suction created by these cups stimulates and increases blood flow, which can help relieve joint and muscle pain, reduce inflammation,
accelerate recovery, increase the function of the lymphatic and circulatory systems and increase overall relaxation and well-being. Cupping may also aid in the healing of scars and surrounding tissues.

There are cases where we do not do cupping, such as:
• Skin Lesions or Inflammation (already present)
• Organ Failure (Renal, Hepatic, and/or Cardiac)
• Pacemakers
• Hemophilia, those on blood thinner medications, or similar bleeding disorders
• Cancer
• Varicose Veins, Spider Veins

Caution should be taken with any of the following conditions, please talk with your practitioner if you are experiencing any of the following:
• Diabetes with complications or an acute infection
• Taking anticoagulant medication ex. Aspirin, warfarin etc.
• Severe chronic diseases such as Heart Disease
• You are pregnant, are within 6 weeks after giving birth, or are menstruating
• Lymphedema or Anemia
• New Tattoos (localized)
• Recently given blood or undergone a medical procedure

I understand that static cupping may result in marks being left on my body and these marks can take anywhere from a few hours to up to two weeks to dissipate. These can look like a bruise.

I understand the cupping marks may or may not be tender to the touch and that I will inform my practitioner if I am
uncomfortable at any time during my treatment.

I understand and I am aware that there can be side effects to cupping such as nausea/vomiting, fainting, blisters/infections, bleeding, bruising, headaches, dizziness, fatigue, and others.

I do not expect the RMT to be able to anticipate and explain all possible risks and complications.

I wish to rely on the RMT to exercise good judgment during the course of the treatment based on her knowledge and in my best interest.

I understand that the results are not guaranteed.

I intend this consent to cover the entire course of treatment(s) for my present and future condition for which I seek treatment.

I have read all above and by “clicking” below, I hereby request and consent to the performance of cupping.