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APPLICATION FORM

Before we can take the next step and you can book an appointment or package with me. I please ask that you fill out the following pre-waiver/application form as a sign of your interest and commitment to making a change in your life and your dedication to working with me on your healing journey.

Application Form

Which session are you interested in booking? Required

Contraindications

Kundalini Bodywork is not recommended for people with:

A personal or family history of epilepsy

Active addiction, severe psychiatric symptoms including active personality disorders and mental illness

Seizures

Cardiovascular problems including angina or heart attacks

High blood pressure

Aneurysms

Glaucoma

Retinal detachment

Osteoporosis

Recent physical injuries, surgery or illness (particularly involving the mouth, teeth, nose, throat, thyroid, immune system, lymphatic system, lungs, chest, ribs, spine and reproductive organs)

Cancellation & Rescheduling  policy 

 

Our time and energy is precious, and I value clients that are committed to their journey, as I am fully invested in you. To limit the amount of cancellations and/or rescheduled sessions, it is necessary that I have the following policy in place, please read carefully; 

 

I understand that if I need to reschedule or cancel my booking I will aim to do so ahead of time. I understand that cancellations or rescheduling must be done at least 48 hours before my session time to avoid any additional cost or forfeit of my session.

 

I understand that Chelsea is happy to offer 1 x reschedule per session, however any additional rescheduling of that same session will incur a $100 fee. 

 

I understand that by rescheduling or cancelling my session within 24 hours, I will forfeit my session and be required to pay any remaining amount. 

Thanks for submitting!

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