Name *
Address *
Medical Conditions
Please tick is you have or are suspected of having any medical conditions in the following areas
Please list any and all medical conditions, write N/A if not applicable so that we know you have read and understood this section.
Please enter your name again as a signature
Opt Out Initial 1-0n-1 Session
If you would like to Opt out of the initial 1-on-1 session please tick the box. By ticking the box you are confirming that you have read our T&C's
Please tick *
Please tick to show that you have read and understood the Teams & Conditions and that you understand the questions in the waiver and answered them to the best of your knowledge

Your health is important to us which is why we are only able to work with you once the waiver has been fully filled out and submitted.  Waivers to not have to be submitted prior consultations.  If you have any questions of concerns regarding the waiver please contact us prior to submitting the form.