Practitioner: Vicky Geary


  • I can ask questions at any time about Esoteric Yoga or any other class.

  • Esoteric Yoga practitioners are not qualified to and nor do they give a medical diagnosis and no esoteric modality offers a cure or any alternative to medical treatment.

  • I understand and accept that I must consult with a registered medical practitioner in the case of any illness or disease or if symptoms persist.

  • The Universal Medicine Therapies are based on The Ageless Wisdom, are complementary-to-medicine, and have not been tested in CONSORT2010-compliant randomised controlled trials.

  • I may withdraw consent at any time by emailing vicky@instillness.com.au.

  • I accept full responsibility for participating in a class.


  • Should I have any current illness or injury, however minor, I understand it is my responsibility to make this known to my practitioner prior to attending the class.

  • I understand and agree that my attendance at each class is at my own risk and the practitioner takes no responsibility for any injury or loss of any description suffered by me or anyone else as a direct or indirect consequence of my attendance at or participation in any class



I consent to my personal and health information, including my history being:

  • processed for the purposes of my treatment, administration and management of the practice, including in my home state and other countries, as needed;

  • discussed with other practitioners including, without limitation, my GP, in order to review the quality of care provided to me;

  • described in a written or verbal referral to any practitioner, should my practitioner feel that such referral is in my best interests, after having first discussed this referral with me;

  • discussed anonymously with other practitioners for the purpose of research and development of esoteric modalities including, without limitation, their integrative qualities with conventional medicine, for the benefit of men and women generally.


  • I consent to the initial and ongoing classes with Vicky Geary

  • I have read, understood and agree to all aspects of this consent form and I consent to treatments with my Vicky Geary as outlined in this form.

  • I agree that this consent form will remain active for future classes and other forms of consultation or advice with this practitioner unless I otherwise notify this practitioner.

  • I acknowledge and agree that this practitioner reserves the right to decline any booking (including mine) for attendance at any class, now or later, or to ask a client (including me) to leave any session at any time, for any reason they see fit.


I certify that the information I have provided above is accurate and complete to the best of my knowledge and, where I have disclosed information in relation to my medical conditions and current medications, that disclosure is complete and accurate.