Aromatherapy consultation form

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Name *
Name
Phone *
Phone
Client Type *
Please list any chronic or acute health issues
Is Your Animal Pregnant? *
Client Goals *
Please choose all that apply
Consent *
I acknowledge that Bridle & Bone Wellness LLC, Heather Wallace, and Danelle Stukas are not medical professionals and will not be held liable in the event my animal has a negative reaction. While rare a negative reaction may consist but is not limited to rash, rubbing, vomiting, or diarrhea. If my animal has these symptoms I will cease use immediately. Bridle & Bone Wellness LLC does not diagnose, prescribe, or treat medical conditions. Aromatherapy is meant to assist self-healing and is not a replacement for medical care.