Consent Form for Sound Bath Name * First Name Last Name Email * Are you pregnant? * Yes No Please indicate if you suffer from any of these conditions Asthma, Cancer, Diabetes, Heart Problems, Hepatitis, High Blood Pressure, Mental Illness, Meniere’s Disease, Osteoporosis, Recent Joint Operations, Epilepsy, Pacemakers, Strokes, Metal plates in body. The date of your consent * MM DD YYYY Your consent A sound healer is not a doctor I consent and confirm I have read the declaration Thank you!