Welcome
Skin
Clear Skin
Clear Inside Out
Skin Conditions
Skincare Application Guide
Health
Wellness
Energy Healing Services
Reiki E-Course
Ailment Meanings
Contact
Release Form
Instagram Links
RELEASE FORM
Does this apply to you?
*
I have a Pacemaker.
I have metal implants.
I am Epileptic.
I am pregnant.
I am on medication. (Topical or Internal)
I have an allergy.
None of the above.
Please list medications and allergies here:
*
*
Indicates required field
This agreement releases Cielo Ruiz from all liability relating to injuries that may occur during any facial, waxing, Reiki, Energy Healing, health or nutritional coaching, Access Bars, cupping, from at-home product recommendations or any injuries obtained in the Ruiz home or property. By signing this agreement, I agree to hold Cielo Ruiz entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I attest that all statements I’ve made on the consultation are true. By signing below I forfeit all right to bring a suit against Cielo Ruiz for any reason. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed. I understand that none of these services are to diagnose or treat medical conditions or replace medical treatments and that results vary. I fully understand and agree to the above terms.
*
I agree
E - Signed
*
First
Last
Email
*
Submit
Before treatment, please remove all jewelry, any metals or cell phones from your body or clothing. Thank you!
Copyright ©2021, Cielo Ruiz. All Rights Reserved