Client Agreement & Informed Consent for Services

I understand that the services offered at Two Rivers Acupuncture, Yoga and Sound Healing LLC, including but not limited to Acupuncture, Shiatsu, Tuina, Yoga, Sound Healing, Energy Work, and related holistic modalities, are intended to support relaxation, stress reduction, and overall well-being.

I acknowledge that these services are not a substitute for medical care, diagnosis, or treatment. I understand that I am responsible for consulting with a qualified healthcare provider regarding any medical condition or concern.

I understand that acupuncture involves the insertion of very fine, sterile needles into specific points on the body to support the flow of energy (Qi), promote balance, and encourage the body’s natural healing processes. I acknowledge that I may experience mild sensations such as tingling, warmth, or temporary discomfort, and I consent to receive acupuncture treatment where applicable. I understand that only licensed practitioners will perform acupuncture services.

I confirm that I have disclosed any relevant health conditions, injuries, medications, or concerns that may affect my session, and I agree to inform my practitioner of any changes to my health.

I understand that bodywork (including Shiatsu and Tuina) is performed fully clothed and may involve therapeutic touch, acupressure, and movement of the body. I consent to receive these services.

I understand that I may decline any technique or stop the session at any time for any reason.

I release and hold harmless Two Rivers Acupucture, Yoga and Sound Healing LLC and its practitioners from any and all liability related to services received, except in cases of gross negligence.

By checking the box below, I acknowledge that I have read, understand, and agree to this Client Agreement and Informed Consent.

Privacy Practices & HIPAA Acknowledgment

Two Rivers Acupuncture, Yoga and Sound Healing is committed to protecting your privacy and maintaining the confidentiality of your personal and health information.

Any information you provide - including health history, contact details, and session notes - is kept confidential and used solely to support your care and provide services.

We will not share your personal or health information with third parties without your written consent, except where required by law.

Your information may be stored securely in electronic or written form and is accessible only to authorized practitioners involved in your care.

You have the right to request access to your records and to request corrections if needed.

By checking the box below, you acknowledge that you have read and understand this Privacy Policy and consent to the collection and use of your information as described.