Schedule Appointment with Sacred Hearth

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
3 Class Pass (In-Studio)		A$65.00
Total: A$65.00

Please read and sign the following, acknowledging that you understand and accept the terms and conditions of your treatment and our provision of services.

I understand and accept that:

I must NEVER attempt to solicit sexual services from the practitioner! ALL inappropriate, disrespectful, offensive, or threatening behaviour, will result in my IMMEDIATE expulsion from the premises, the cancelation of any pre-booked appointments, a lifetime ban from attending all Sacred Hearth appointments, classes, events and workshops, and the potential filing of a police report.
I am not welcome to visit the Sacred Hearth business location without an appointment or prior approval! The studio location is a home before it is a business, and it is important for me to observe and respect this personal boundary. I will ALWAYS ensure that I have a scheduled appointment before attending the premises and will not arrive earlier than my scheduled appointment unless I have sought and received, either by phone or email, prior permission. If I seek permission and do not receive a response, then I will assume that I do not have permission and will arrive at my original scheduled appointment time. If I do not have an appointment, then I do not have permission to be on the premises and I will be asked to leave. If I attend the premises without permission and my behaviour is in any way inappropriate, disrespectful, offensive, or threatening, then the police will be contacted without hesitation.
Sacred Hearth and its practitioners have the right to refuse service to anyone for any reason providing that refusal does not violate anti-discrimination laws.
I am responsible for my own appointments. All text and email confirmations and reminders are a courtesy. At least 24 hours’ notice is required when cancelling or rescheduling an appointment. If I cancel/reschedule within 24 hours of my appointment, I am financially obligated to pay 50% of the total service fee. If I cancel/reschedule within 12 hours of my appointment, or I miss it entirely without notice, I am financially obligated to pay 100% of the total service fee. Late arrivals will incur the full appointment fee, regardless of treatment length upon arrival. All outstanding fees must be paid before any further treatment will be provided.
I am financially obligated to pay the set service fee prior to the commencement of my treatment. The practitioner is under no obligation to offer refunds or discounts if I feel I am entitled or unsatisfied.
Sacred Hearth is a Natural Complimentary Therapy practice, not a Medical Clinic, therefore the practitioner does not diagnose illness, disease, or other physical, mental, or psychological disorders. As such, the practitioner neither prescribes medical nor pharmaceutical treatment, or any form of supplement. However, they may prescribe stretches and or exercises, and recommend products to assist with the care and treatment of joint and muscular dysfunction.
Sacred Hearth is legally required to collect and store both contact information and detailed health histories for ALL clients attending 1:1 appointments. I am required to inform the practitioner of all medical conditions that I may be suffering from, including (but not limited to) injuries, physical/mental illness, recent surgeries or medical treatments, and medications being taken, and I am required to keep this information up to date by informing the practitioner of any changes to the information I provided as of my last visit.
Hygiene and infection control procedures are in place to protect me, the practitioner, and others who may attend the studio, however, the practitioner cannot be expected to anticipate or guard against all potential risks associated with therapeutic intervention. By providing accurate information regarding my own health, I assist the studio in reducing potential risks.
I accept responsibility for my own health and wellbeing. Sacred Hearth’s wellness therapies are not a substitute for personal responsibility. They do not cure illness, disease, or dysfunction, nor do they claim to. If I am seeking therapeutic intervention as a means of absolving myself of personal responsibility, I may be asked to seek alternative healthcare services.

I verify that I have read, understood, and accepted all the Terms and Conditions of my treatment, and the provision of services.