Client Referral Information
I, the undersigned Client, herby authorize / consent to allow Certified Practitioners of Y'Her Estheticians & Wellness Spa, to perform alternative therapies. The therapies offered to me are Colon Hydrotherapy. Colon Hydrotherapy is not intended to replace the relationship with your primary health care providers and my consultation is not intended as a Colon Hydrotherapist is not medical advice. They are intended as a sharing of knowledge and information from my education, research, training, and experience. As a Colon Hydrotherapist, I encourage you to be open to new information on the effectiveness of Colon Hydrotherapy and the fundamental role of diet, exercise, supplementation, stress management and emotional and mental work. I encourage you to make your own health decisions based upon your research and in partnership with your primary health care providers, ND, MD or otherwise.
The procedure has been explained and all my questions have been answered before the session, and I agree to participate.
I have read this entire document which is provided in a language I can read and completely understand.
My signature below indicates this as true.
Thanks for submitting! Please follow the instructions of the Therapist. You must be always draped/covered.
This facility does not claim to cure or treat any condition or disease.
