Book a Free Consultation

Or Shoot us a quick email

(404) 530-6433 | [email protected]

Now Serving at 4880 Lower Roswell Road, Marietta GA, 30068 in Explore Health and Wellness by Appointment only

Massage Therapy Consent Form

Please complete this to receive Massage Therapy

By Clicking the ecstatic "Yes!" button 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 prescribe medications.

4) I have clearance from my physician to receive massage therapy.

5) I understand the risks associated with massage therapy include, but are not limited to:

Superficial bruising
Short-term muscle soreness
Exacerbation of undiscovered injury

I therefore release the company and the individual massage therapist from all liability concerning these injuries that may occur during the massage session.

6) I understand the importance of informing my massage therapist of all medical conditions and medications 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.

11) I agree to receive contact from Rooted In Love about Massage Therapy.

10) I am a clear and present vessel 🙏🏻🙌🏻

Click Yes! to submit your intake form

Book a Free Consultation

Or shoot us a quick email

(404) 530-6433 | [email protected]

Now Serving at 4880 Lower Roswell Road, Marietta GA, 30068

in Explore Health and Wellness by Appointment only

Massage Therapy Consent Form

Please complete this to receive Massage Therapy

By Clicking the ecstatic "Yes!" button 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 prescribe medications.

4) I have clearance from my physician to receive massage therapy.

5) I understand the risks associated with massage therapy include, but are not limited to:

Superficial bruising
Short-term muscle soreness
Exacerbation of undiscovered injury

I therefore release the company and the individual massage therapist from all liability concerning these injuries that may occur during the massage session.

6) I understand the importance of informing my massage therapist of all medical conditions and medications 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.

11) I agree to receive contact from Rooted In Love about Massage Therapy.

10) I am a clear and present vessel 🙏🏻🙌🏻

Click Yes! to submit your intake form

Christina Belue

(404) 341-5445

[email protected]

LMT #013853

© 2022 by Rooted in Love

Privacy Policy

Christina Belue

(404) 341-5445

[email protected]

LMT #013853

© 2022 by Rooted in Love

Privacy Policy