SOUND HEALING – CLIENT ACKNOWLEDGEMENT & CONSENT FORM

Academy of Sound Healing

A non for profit, International Sound Healing, Training and Research Organisation

Registration No: SO219718 under W.B. Act XXIV of 1961, INDIA
PAN: AADAA8276A
GST: 19AADAA8276A1ZU

NITI Aayog, Govt of India, Registration ID: WB/2020/0249276

All donations made to Academy of Sound Healing are exempt from Income Tax under section 80G in India.

Client Details

Full Name

Preferred Name

Address

City

State

Country

Zip Code

Email*

Mobile / Landline*

Gender

DOB

Aadhar No

Occupation

Client Photo
Only JPG, PNG,JPEG and PDF files are allowed

Client ACKNOWLEDGEMENT & CONSENT

I hereby discharge the therapist and the institute of any contractual obligation.

Therapist email id:

I am completely aware of the sound healing modality with Singing bowls and I am giving authority to the therapist to work on me. I have been explained in details how therapy works and I have been duly informed of the modality and the functioning of the therapy. I understand the limitation of the therapy and understand that the result of the therapy also depend upon a lot of external factors and my efforts.

I am also giving the consent to record my session and document my case and use it as a part of IASH sound healing research work.

Client’s Signature
(or Signature by Parent/Guardian in case client is under age of 18)

Date