Welcome to Your Wellness Journey

Thank you for taking the time to read through this release and waiver. This document is an important step to ensure clarity and mutual understanding. It explains the nature of the treatments offered, outlines any potential risks, and confirms that you take personal responsibility for your own wellbeing during and after each session. By signing, you acknowledge that these treatments are supportive wellness practices and not medical procedures, and you release me from any liability connected to your participation.

Release and Waiver of Liability

For the purposes of this Release and Waiver, the term "Releasees" refers collectively to:

  1. Practitioner: Samantha Roze

  2. Entity: Complementary Therapist

I, ("the Releasor"), acknowledge and agree that my participation in any treatments, consultations, and/or sessions with the Releasees, including but not limited to:

  • Breathwork

  • Lymphatic Drainage Massage

  • Lipogenie Treatments

  • Reflexology with Lymphatic Drainage

  • Any other wellness treatments offered

is subject to the following terms:

Understanding of Services

a) Not Medical Treatment: I understand that these sessions are not a substitute for medical care or advice from my doctor or primary healthcare provider.

b) No Medical Claims: I understand that the Releasees do not provide medical guidance, diagnosis, prescriptions, or treatment for any health condition.

c) Wellness Support Only: I acknowledge that all treatments are intended as supportive wellness practices only.

Physical Contact and Consent

I understand that sessions may involve physical touch as part of the treatment process, and I have the absolute right to decline this at any point by saying "stop" or withdrawing consent.

Medical Disclosure and Personal Responsibility

I acknowledge that it is my responsibility to disclose any and all medical conditions, medications, or health concerns to the facilitator prior to treatment, including but not limited to:

General Contraindications:

  • Pregnancy or suspected pregnancy

  • Cancer (active or in remission within the last 5 years)

  • Recent surgery or post-operative recovery

  • Blood clots, deep vein thrombosis (DVT), or thrombosis

  • Congestive heart failure or severe heart conditions

  • Kidney or liver disease

  • Active infections, fever, or contagious illness

  • Skin conditions, open wounds, or recent burns in treatment areas

  • Epilepsy or seizure disorders

  • Acute inflammation or swelling

  • Uncontrolled hypertension (high blood pressure)

  • Diabetes (particularly uncontrolled)

  • Osteoporosis or bone fragility

  • Varicose veins or vascular conditions

  • Implants, pacemakers, or medical devices

  • Autoimmune disorders

  • Recent fractures or injuries

  • Medication that affects blood clotting or circulation

Mental Health Conditions:

  • Bipolar disorder

  • Schizophrenia or psychotic disorders

  • Severe anxiety or panic disorders

Breathwork-Specific Considerations:

  • Asthma or respiratory conditions

  • Hyperventilation syndrome

  • Recent head injury or concussion

Treatment-Specific Considerations:

  • Recent cosmetic procedures or injections (for facial treatments)

  • Menstruation (may affect comfort during certain treatments)

  • Use of blood thinners or anticoagulant medication

I understand that while I may be accepted into a session following disclosure, I remain fully responsible for any outcomes or consequences arising from my participation.

Medical Consultation

I confirm that I have sought or will seek appropriate medical advice regarding any physical, mental, or emotional condition that could affect my health during or after treatment. I understand that I should consult with my healthcare provider or doctor if I suspect I have or develop any health issues, or if I have any concerns about whether these treatments are appropriate for my current health status.

Complementary Health Approach

I understand that I am encouraged by Samantha Roze to make health decisions in partnership with my medical providers and to consider the broader role of lifestyle factors such as nutrition, exercise, rest, emotional wellbeing, and stress management alongside any wellness treatments received.

Voluntary Participation and Assumption of Risk

By taking part in any session with the Releasees, I do so voluntarily and at my own risk. I understand that:

  • Individual results may vary

  • Treatments may cause temporary discomfort, fatigue, emotional release, or detoxification symptoms

  • I should communicate any discomfort or concerns during treatment

  • I am free to stop treatment at any time

  • I am responsible for following any aftercare advice provided

Release of liability :With full understanding of the above, I knowingly and willingly sign this Release and Waiver.

By submitting the form below: I, on behalf of myself, my heirs, and my assigns, hereby release and forever discharge the Releasees from any and all actions, claims, complaints, damages, costs, or expenses of any kind, arising from or connected to any discussions, consultations, breathwork sessions, lymphatic drainage treatments, lipogenie treatments, reflexology sessions, or any other wellness treatments I have had or may have with the Releasees.

Client Information and Acknowledgment

I confirm and acknowledge the above. I have read this waiver in its entirety, understand its contents, and agree to be bound by its terms. I acknowledge that I am signing this document voluntarily and that no representations or inducements have been made to me other than those contained in this document.