(404) 530-6433 | [email protected]
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
(404) 530-6433 | [email protected]
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
© 2022 by Rooted in Love
© 2022 by Rooted in Love