I _______________________________________ (client’s name), understand that massage therapy provided by ATLAS BODY RESET is intended to enhance relaxation, reduce pain caused by muscle tension, increase range of motion, improve circulation, and offer a positive experience of touch. Any other intended purposes for massage therapy are specified below:
The general benefits of massage, possible massage contraindications, and the treatment procedure have been explained to me. I understand that massage therapy is not a substitute for medical treatment or medications, and that it is recommended that I concurrently work with my Primary Care Provider for any condition I may have. I am aware that the massage therapist does not diagnose illness or disease, does not prescribe medications, and that spinal manipulations are not part of massage therapy.
I have informed the massage practitioner of all my known physical conditions, medical conditions, and medications, and I will keep the massage practitioner updated on any changes. I understand that there shall be no liability on the practitioner’s part due to my forgetting to relay any pertinent information.
If I experience any pain or discomfort during the session, I immediately communicate that to the practitioner so the treatment can be adjusted.
I have received a copy of the practitioner’s policies, I understand them and agree to abide by them.
Date _________________________
Client’s Name (Print) ______________________________________
Client’s Signature ______________________________________