First Animal Client Intake Form

Declaration

I declare that the information provided above is true and correct to the best of my knowledge and indemnify Mervin Wilk / Heart of Mervin against any liability arising from false or misleading information supplied.

I understand and acknowledge that the kinesiology session provided by Mervin Wilk is a complementary wellness service designed to support the emotional, energetic, behavioural and physical wellbeing of my animal. It is not intended to diagnose, treat, cure or prevent any medical condition and is not a substitute for veterinary care, diagnosis or treatment.

I understand that outcomes may vary between animals and that no specific results or guarantees can be provided.

I acknowledge that all information collected, together with session notes and records, will be kept confidential and stored securely in accordance with privacy requirements and professional record-keeping practices.

I understand that payment is required at the time of booking. Cancellations and rescheduling are subject to the Heart of Mervin Terms of Service linked below.

I hereby give permission for Mervin Wilk to conduct kinesiology balancing sessions with my animal.

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