A massage therapy appointment is provided for the basic purposes of relaxation and reduction of muscular tension. I understand that massage therapists are not qualified to perform spinal adjustments, diagnose, prescribe or treat any medical condition. If I have a specific medical condition, massage may be contraindicated and a letter of approval from my primary care provider may be necessary prior to the session. If I experience any pain or discomfort, I will immediately inform the therapist so that the pressure may be adjusted to my level of comfort. I also understand that massage should not be construed as a substitute for medical diagnosis or treatment and should see a physician or other qualified medical specialist for any mental or physical ailment of which I am aware. I understand we reserve the right to immediately discontinue a session or decline future treatments due to any inappropriate behavior. I affirm that I have stated all of my known medical history and agree to keep my massage therapist updated to any changes in my condition, nor shall there be any liability on the therapist’s part should I forget to do so. I am aware of the 12-hour cancellation policy and that I will incur the cost of the session without 12 hours’ notice. *
Please sign below with your full name and date!