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Feel This Free Liability Waiver

First Name

Last Name

Date of Birth

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Please specify anything we should know about

Please Check off all Sections

I give my permission to receive massage therapy.

I understand that therapeutic massage is not a substitute for traditional medical treatment or medications

I have clearance from my physician to receive massage therapy.

I understand that the massage therapist does not diagnose illnesses or injuries

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.

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

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

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

I agree to the terms & conditionsView terms of use

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Please Download and Fill Out the Appropriate Forms Below.

Basic Intake Form

Download Form

Hot Stone Intake Form

Download Form

Prenatal Massage Intake Form

Download Form

Reflexology Intake Form

Download Form

Subscribe Form

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