PLEASE carefully read the following:
It is my choice to receive massage therapy. I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. IF I experience any discomfort or pain during my session, I will immediately inform my therapist so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage should not be construed as a substitute for a medical examination, diagnosis, or treatment and that I should see a physician or another qualified medical specialist for any mental or physical ailment. I understand that massage therapists are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such. Because massage should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep my therapist, Grace McDonald, LMT updated as to any changes in my medical profile and understand that there shall be no liability on my therapist's part should I fail to do so.
I understand that my personal health information will be collected via this HIPAA compliant form and that ALL information I provide WILL be kept confidential.
By signing below, I agree to release Grace McDonald, LMT and Graceful Touch Massage Therapy from any liability, and I hereby waive any damages in connection with the massage therapy and bodywork I receive to the fullest extent permitted by NY State law.
I agree that this Release/Waiver is in effect for all massage therapy/bodywork sessions and will not terminate unless requested, in writing, by either party.