Consent

Stop Existing and Start Living!

Complete the consent as provided below, once completed you will then be automatically directed to the Conscious Apothecary where you can select and make payment for your selected product to finalise your order.

Confidentiality: Your responses to the questionnaires will always be kept confidential.

Informed Consent:

  • I understand that this consultation is designed to gather information so that the practitioner can design and create aromatic products based upon my individual needs and for the express purpose of supporting health and well-being through lifestyle changes, health habits, and healthy mental well-being.
  • I understand that my aromatherapy practitioner does not diagnose, prevent, or treat any illness, disease, or any other physical or mental condition.
  • I understand that this treatment is not a substitute for medical treatments, and it is recommended that I see a qualified professional for any physical or mental condition that I may have.
  • I understand that any evaluation cannot determine a specific disease condition I may have, and that it does not replace the diagnostic services offered by licensed physicians.
  • I understand that there is no advice or suggestion that I cease medical care I am undertaking.
  • I understand that the decisions I make regarding my health care are my sole responsibility.
  • I understand that any instruction, advice, counsel, suggestions, recommendations, services, or products are provided solely for the purpose of supporting the natural function of the body systems, and to improve general health and well-being.
  • I have read the above information and I hereby give my permission for Nukubi Aroma Therapy to design an aromatic blend for me based upon my unique needs and goals.
  • I confirm that the information given is true to the best of my knowledge and I undertake to inform the therapist of any changes as they may occur.

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