I hereby give my voluntary consent for Arsenal Performance and Rehabilitation (hereinafter referred to as "the Clinic") to provide me with medical treatment and related services. I understand that the Clinic will aim to provide me with the best possible care, utilizing their professional expertise and judgment.

I understand that the nature of the treatment may include, but is not limited to, physical therapy, rehabilitation exercises, manual therapy, therapeutic modalities, and other related services as deemed necessary by the Clinic's healthcare providers.

I understand that the Clinic's healthcare providers will explain the proposed treatment plan to me, including the risks, benefits, and alternatives, to the best of their ability. I acknowledge that I have the right to ask questions and seek clarification about any aspect of my treatment.

I understand that while the Clinic will take all reasonable precautions to ensure my safety during treatment, there are inherent risks associated with any medical intervention. I accept responsibility for any consequences that may arise from these risks.

I understand that I have the right to refuse any treatment or intervention recommended by the Clinic's healthcare providers. I acknowledge that if I choose to refuse treatment or any part of the recommended plan, it may affect the outcome of my rehabilitation.

I understand that my personal health information will be kept confidential in accordance with applicable laws and regulations, and will only be disclosed with my consent or as required by law.

I hereby release the Clinic, its healthcare providers, employees, and affiliates from any liability arising from the provision of medical treatment and related services, except in cases of gross negligence or willful misconduct.

I certify that I have read and understood the contents of this consent form, and I freely and voluntarily consent to receive treatment from Arsenal Performance and Rehabilitation.

Please provide e-signature below.