this may be an individual, physician or healthcare practitioner, online portal, or social media
-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 of 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 have read and understand the policy regarding sensual/sexual/erotic massage and understand that disregarding this policy will result in immediate termination of the session without refund and in some cases may be reported to the appropriate local authority.
Entering your name here is considered your digital signature and means you have read, understood, and agreed to the information in this form.