1. I understand that massage or bodywork may be contraindicated for certain medical conditions or symptoms. A referral from my physician or licensed health care provider may be necessary prior to service being provided.
2. I further understand that massage or bodywork is provided for the purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during my appointment, I will inform the therapist so that the pressure or strokes may be adjusted accordingly.
3. I understand that massage or bodywork should not be perceived by me as a substitute for medical examination, diagnosis, or treatment and that I should consult a physician, chiropractor, or other qualified medical specialist for any mental or physical condition that I am aware of.
4. I have been informed that massage and bodywork therapists are not qualified to perform skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said during the session should be perceived as such.
5. I understand that our massage therapists are trained professionals. At all times I will adhere to state and ethical compliant rules on draping and etiquette. Under professional guidelines our massage therapist employs full sheet draping to protect client modesty. The practitioner maintains the right to terminate a bodywork and massage session at will. I understand that any remarks or actions of a sexual or personal nature will result in immediate termination of the session and that no future appointments will be allowed.
6. Because massage or bodywork should not be performed under certain medical conditions, I attest that I have stated all my known medical conditions and answered all questions honestly. I accept and voluntarily assume all risks of injury, damage, or harm which may arise during or as a result from my participation in massage or bodywork.
7. I understand that all session times include 50 minutes of hands-on bodywork if I arrive on time to my appointment.
8. I understand that I am responsible to be on time for my appointments and that the therapist is not under any obligation to extend my therapy session. I also agree that I am responsible to pay for the full time I have booked with the therapist if I am late. If I miss an appointment or am unable to give 24 hour-notice when I need to change my appointment, I agree to pay a $10 fee that will be held on my account until paid. I understand that my appointment will be considered a no-show if I arrive 15 minutes or more past the scheduled appointment time.
9. I represent I am at least 18 years of age and have read and understood this Informed Consent.
Client Signature:
____________________________________________________Date:________________________ Briefly explain any conditions mentioned above: _______________________________________________________________________________________________
By signing below, you agree to the following. I have completed this form to the best of my ability and knowledge and agree to inform my therapist if any of the above information changes at any time.
_____________________________________________________________ Date ______________________________
