Waiver & Check- In

Subtle Nectar Wellness Clinic

Disclosure Statement & Informed Consent for Care

Nature of the Community Wellness Clinic

The Subtle Nectar Community Wellness Clinic is a collaborative wellness offering that brings together independent, licensed and/or certified holistic health practitioners to provide short, introductory sessions in a community setting.

Services offered may include, but are not limited to:

• Massage therapy and bodywork

• Acupuncture and Traditional Chinese Medicine

• Nutrition and lifestyle coaching

• Naturopathic and holistic health consultations

• Somatic and integrative wellness modalities

Each practitioner operates independently and is responsible for their own scope of practice, licensure, and professional standards.

Scope of Care & Medical Disclaimer

The services provided at this clinic are not a substitute for medical diagnosis, treatment, or emergency care.

I understand that:

• Practitioners at this clinic may not be medical doctors (MDs or DOs).

• Services offered are complementary and holistic in nature.

• I am encouraged to maintain a relationship with a licensed medical provider for medical conditions, diagnoses, or prescriptions.

I understand that I should seek immediate medical attention for any urgent or emergent health concerns.

Risks & Acknowledgment

I acknowledge that all wellness and body-based services involve some level of risk. Possible risks may include, but are not limited to:

• Temporary soreness, discomfort, or fatigue

• Emotional release

• Lightheadedness or dizziness

• Bruising or tenderness

• Allergic reactions or sensitivities

I agree to inform my practitioner of all relevant health conditions, injuries, allergies, medications, pregnancy, or medical concerns prior to receiving care.

Consent & Voluntary Participation

I understand that:

• Participation is voluntary

• I may decline or stop a session at any time

• I may ask questions before or during my session

• Results are not guaranteed
  

I consent to receive care from the practitioner I select, understanding the nature and scope of services offered.

Payment & Clinic Structure

I understand that:

• Each practitioner manages their own session sign-ups and payments

• Session fees are typically sliding scale and paid directly to the practitioner

• Subtle Nectar Wellness coordinates the clinic but does not provide individual treatment
  

Release of Liability

I agree to release and hold harmless Subtle Nectar Wellness, the Community Wellness Clinic, its organizers, volunteers, and participating practitioners from liability for any injury or adverse effects arising from my participation, except in cases of gross negligence or willful misconduct.

Acknowledgment & Signature

I confirm that I have read and understand this disclosure.

I have had the opportunity to ask questions.

I voluntarily consent to receive care at the Subtle Nectar Community Wellness Clinic.

Community-Supported Gathering

Suggested contribution $5–$20.

Give what feels right—your support helps keep care accessible and the community thriving.