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Health Waiver

Please fill out the following form
in order to participate in our activity.

​

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 the massage therapist does not diagnose illnesses or injuries, or prescribe medications.

4) I understand the importance of informing my massage therapist of current medical conditions and any changes to these.

5) I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during my massage session so it may be adjusted accordingly.

6) I understand that I or the massage therapist may terminate the session at any time.

7) I understand the risks associated with massage therapy:

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

8) I have been given a chance to ask questions about the massage therapy session.

Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?

Thanks for submitting!

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