** Items Necessary For Your Visit **
- Current Valid Photo ID
- Facial Mask Required To Be Worn Throughout Entire Appointment
It is my choice to receive massage therapy. I am aware of the benefits and risks of massage and give my consent for massage.
I understand that there is no implied or stated guarantee of success or effectiveness of individual techniques or series of appointments. I acknowledge that massage therapy is not a substitute for medical care, medical examination or diagnosis.
I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status.
I understand that my personal health information will be collected. I understand that all information that I provide will be kept confidential unless required by law. I understand and consent that my medical information may be shared by the various care providers involved in my care and treatment.
By signing below, you agree to the following:
1. I give my permission to receive massage therapy.
2. I understand that therapeutic massage is not a substitute for traditional medical treatment or medications.
3. I understand that the massage therapist does not diagnose illnesses or injuries, or perscribe medications.
4. I have clearence from my physician to receive massage therapy.
5. I understand the risks associated with massage therapy include, but are not limited to:
I therefore release the company and the individual massage therpist from all liability concerning thes injuries that may occur during the massage session.
6. I understand the importance of informing my massage therapist of all medical conditions and medications that I am taking, and to let the massage therapist know about any changes to these. I understand that there may be additional risks based on my physical condition.
7. I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during the massage session so he/she may adjust accordingly.
8. I understand that I or the massage therapist may terminate the session at any time.
9. I have been given a chance to ask questions about the massage therapy session and my questions have been answered.