Sana Luna Acupressure — Informed Consent Form
Sana Luna Acupressure — Informed Consent Form
I, the undersigned, hereby voluntarily consent to receive acupressure wellness services and/or Sana Luna skincare treatments provided by the practitioner named below.
I understand that acupressure is a non-invasive, traditional wellness technique that involves the application of gentle, localized pressure to specific points on the body, known as meridians. These techniques are intended to support relaxation, relieve tension, and promote the body’s natural balance and well-being.
During treatment, the practitioner may use specially designed external tools—such as smooth, rounded probes—to stimulate these points. These tools do not puncture the skin and are not used for any medical, diagnostic, or invasive purpose.
I acknowledge the following:
- Acupressure is a complementary wellness practice and does not replace medical care.
- The practitioner is not a licensed medical doctor and does not diagnose medical conditions, prescribe medication, or perform medical procedures.
- Any reference to “organ systems” during treatment refers solely to traditional energetic pathways, not the anatomical or clinical function of internal organs.
- Some mild side effects may occur, such as temporary soreness, light bruising, or slight discomfort at pressure points.
- I may stop or refuse treatment at any time.
- No guarantees are offered regarding the outcomes of the services provided.
- I consent to the use of de-identified session data for educational or research purposes, if applicable.
I acknowledge that I have read (or had read to me) this informed consent in its entirety. I have had the opportunity to ask questions and understand the nature, purpose, potential risks, and benefits of the services offered. I consent to receive treatment now and in the future under the scope of practice described.
Client Signature: _________________________________
Date: _________________________________
Practitioner: Caren Rodriguez Huerta
Certified Acupressure Specialist
Sana Luna Acupressure