|
Spiraling Upward
Informed Consent CYMATHERAPY®/CYMATIQUE®
Introduction: Cymatherapy® and Cymatique® are a non-invasive, sound therapy that helps restore the body to optimal health, balance and function. It uses advanced instruments to transmit frequencies to the body’s organs and tissues that are associated with healthy cells and healthy cell function, supporting the body’s natural healing abilities.
A trained Cymatherapy® practitioner selects the programs for the Cyma® 1000 to deliver the exact combination of frequencies to be used. The applicator of the Cyma® 1000 is placed on the surface of the skin. Cymatherapy® and Cymatique® administered by a qualified practitioner are safe, irrespective of the client’s age or level of fitness. Cymatherapy® was the groundbreaking work of Dr. Peter Guy Manners a renowned physician from the United Kingdom, and is a new and advanced form of sound therapy. Another example of acoustic or sound therapy is the therapeutic ultrasound therapy being used in rehabilitation today.
Cymatherapy® and Cymatique® involve the application of gentle, audible, sound with a hand held applicator/massager on my body for an average of 20 to 60 minutes during my scheduled visit. Cymatherapy® and Cymatique® can be used safely in addition to any standard medical treatments prescribed to me by my doctor or other qualified healthcare provider.
Description of the session: I understand that Cymatherapy® or Cymatique® involve the application of a gentle sound therapy with a hand held applicator/massager, to my body. I understand that there have not been any documented complications of Cymatique® or Cymatherapy®. While in the Cymatherapy®/Cymatique® program, I agree to the following:
· To keep my scheduled appointments to receive Cymatherapy® or Cymatique®. · To fill out any forms used to evaluate my health. · To fill out forms needed to monitor the results of Cymatherapy® or Cymatique®.
Risks: I understand that the risks involved in my participation are thought to be very minimal as no side effects have ever been reported in over 50 years of use. I realize that the side effects of Cymatherapy® or Cymatique® have not been described in the literature. The risks of taking part in this session have been explained to me and I am willing to accept them.
Spiraling Upward, LLC 12706 Larchmere Blvd. Cleveland, OH 44120
Mary Patterson mary@spiralingupward.org
Patricia Sage patricia@spiralingupward.org |