INDEMNITY
TRE® is not intended to diagnose, treat, cure, or prevent any disease. TRE® is a safe and effective stress release technique for most people.

The TRE® process should not be used as a substitute for trauma recovery procedures of a medical or psychiatric/psychological nature. Individuals who have physical or psychological conditions that require strict regulation, individuals with fragile psychological defences, a complex history of trauma or restricting physical or medical limitations should consult their medical professional prior to performing these exercises. Results may vary between individuals. There are no guarantees, expressed, or implied.

CONFIDENTIALITY
Everything discussed within the confines of the time of our work together shall remain confidential and shall not be divulged to any third party with the exception of the referring practitioner. If participating in group work, no identifying material is to be divulged outside of the group.

RELEASE
I, acknowledge that I am voluntarily participating in private or group session in TRE® of my own volition. I am aware that, by practicing TRE®, I assume and accept the risk of any adverse outcome that might result. I understand that I can stop my participation any time I wish, and that I am in control of the intensity at which I perform TRE®. I accept full responsibility for any side effects or changes in my life that performing TRE® may cause.

I am aware that, although Deva Laya Guleng is a certified TRE® provider/Trainer, she’s not a licensed physician and therefore do not provide medical advice. I recognise that she does not recommend that I stop using prescribed medicine, treatments, or mental health counseling without consulting my doctor or counselor.

I agree to take full responsibility for my own physical and emotional health and hold Deva Laya Guleng, and OmniBalance, harmless from any legal, financial, and medical liability arising from my tlearning process.

TEACHING TRE® TO OTHERS
I acknowledge that I am not a certified provider of TRE® after attending one-on-one sessions or group-sessions, and am therefore not trained to teach others how to do it after attending the session (private/group). If I teach TRE®, I accept full liability for any claim, suit, or proceedings brought against me by anyone I teach, thereby releasing Deva Laya Guleng, OmniBalance, TRE® LLC, and Dr. David Berceli from any legal, financial, and medical liability that may be incurred.













    If yes, please describe your experience of TRE® - how long you’ve been practicing, where and when you learned, how often you shake and any significant changes that have occurred.


    Please provide details of any heart conditions, irregular blood pressure, epilepsy, diabetes or ongoing chronic pain.

    Please include details of any problems with your ankles, knees, hips, spine or neck:

    If yes, please explain:

    Please provide details of any treatment you've received within the last 12 months.


    Hardly ever Monthly Weekly Daily
    Headaches / migraines
    Back, neck, shoulder pain
    Pelvic pain
    Knee pain
    Fibromyalgia
    Allergies
    Digestive issues
    Nausea
    Worry
    Anger/rage
    Sadness
    Lack of energy
    Insomnia
    Irritability
    Depression
    Anxiety
    Panic attacks

    If you have any of the following conditions, please select yes or no.

    IMPORTANT: If you have any of the following conditions we advise that you only work with Certified TRE® Providers whose scope of practice includes experience in the treatment of these conditions. (If you have a therapist or friend you may bring them with you to learn TRE® too or support you with your TRE® in your one-to-one session.) And do not do your first few sessions of TRE® in a group.




    1= not at all stressed; 5 = very stressed


    Hint: Use your mousecursor with the left mousebutton pressed and write your signature in the field to confirm the disclose requirements.