Diseases, Duration, Medications
If you have any above problems or any other problems not mentioned above we recommend you to consult our doctors prior to treatment / Therapy. I understand that the therapies provided to me by therapists takes utmost care while performing the therapy. I have been updated on any unforeseen complications by experts. Affixed is my signature indicates that I understood all of the above information. With this in mind, I hereby consent to treatment performed at House Of Ayurveda.
Signature of Patients Parent/Legal Guardian (if Patient is Under 18):
Date