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Package – 10 Session Bioenergetic

About You

Your Name(Required)
Preferred pronouns(Required)
Do you want an insurance receipt?(Required)
Verify with your provider that they cover Naturotherapists covered with the ACNN (Academy of Naturopaths and Naturotherapists of Canada).
Your Address (If you require an insurance receipt)
By signing this form I consent to a Naturotherapy session using Somatic and Bioenergetic modalities. I recognize that at times I release Rio from all responsibility from whatever may come up for me emotionally during or following the session.
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