Informed Consent Form

I understand that the state of Ohio issues licenses to health and wellness professionals authorizing them to analyze, assess, diagnose, evaluate, examine and investigate their patients to determine what's wrong with them. This license also authorizes them to advise, caution, counsel, guide, prescribe, recommend and suggest cures, drugs, interventions, remedies and treatments to address what's wrong with them. I understand that Alicia Hayles will refer me to a properly licensed professional if I need -- or if I feel I need -- a specialist to diagnose, treat, counsel or cure me of anything.

I understand Alicia Hayles is a Certified Vibrational Sound Coach through Natural Therapies Certification Board (NTCB) who uses tuning forks to help me: relax, reduce stress and anxiety; reconnect with my inner energy potential using the ancient Solfeggio frequencies to balance and restore harmony in my life; and free blocked energy, thereby creating openings in which novel choices are awakened and new-found energy becomes available for personal transformation, health and healing.

I understand that my health is my responsibility and I am responsible for my own health, healing and well-being. I understand natural healing is not a substitute for adequate medical care and I intend to remain under the care of my primary healthcare provider. I understand that Alicia Hayles is serious about practicing Vibrational Sound ethically, legally, and being a professional in every way.

I understand that if I have -- or if I think I have -- a medical concern, condition, disease, disorder, issue or symptoms, Alicia Hayles will help me reduce any related stress and refer me to a licensed chiropractic, medical or osteopathic physician for further assistance. I also understand if I have -- or if I think I have -- a psychological or emotional concern, condition, disease, disorder, issue or symptoms, Alicia Hayles will help me reduce any related stress and refer me to a licensed counselor, psychologist or psychiatrist for further assistance.

I acknowledge that I have read and understand this form. I agree to allow Alicia Hayles to help me learn to heal myself using the natural healing techniques and modalities herein listed