Consent form for massage clients

ClientConsentForm
IunderstandthatthemassageIreceiveisprovidedforthebasicpurposeofrelaxationandrelief
ofMuscleTension,Injury,orSportsRelated.Massageshouldnotbeperformedundercertain
medicalconditions,IaffirmthatIhavestatedallmyknownmedicalconditions,answeredall
questionshonestly.Iagreetokeepthetherapistupdatedtoanychangesinmymedicalprofile
andunderstandthatthereshallbenoliabilityonthetherapist’spartshouldIfailtodoso.Clients
willbedrapedatalltimesexceptforareabeingtreated.Ifdrapingisnotused,clientwillbein
workoutclothingandproperlydressed.Thisisanonsexualmassagetreatment.Any
misconstruedacts,themassagetreatmentwillbestoppedandclientwillbeaskedtoleave
inaccordancetoArizonaStateLaw.
ClientAgreement&HealthReleaseForm
Releaseofmedicalrecords
Iauthorizethereleaseofmedicalrecordsorotherhealthcareinformation,includingintake
forms,chartnotes,reports,correspondence,billingpayments,andotherwritteninformationto
myattorneys,healthcareproviders.
(PleaseinformyourpractitionerimmediatelyuponsigninganyexclusiveReleaseofMedical
Recordswithyourattorneythatmayimpacttheabovereleasestatement.)
CancellationPolicy
The24houradvancenoticeisrequiredwhencancellingamassageappointment;ifyou’reunable
togiveusthenoticeyouwillbechargedthefullamountofyourappointment.Weunderstand
thatunanticipatedeventshappenoccasionallyineveryone’slifeandarehappytohonoryour
businessasfollows.Ifthereareanyhealthissuespresentatthetimeofyourscheduledmassage
orthatmightmakemassageabadidea,includingfever/cold/flu/sickness,pleasecontactus
BEFOREattendingarrivingforyourmassage.Ifyouarepregnantatthetimemassage
appointment,pleasecontactusbeforearrivingforyourmassage.
Noshows
Anyonewhofailstoshowupforascheduledmassageappointmentanddoesnotprovide24
hours’cancellationnotice,willbeconsidereda“noshow”andwillbechargedthefullamount
forthemissedappointment.
LateArrival’s
Outofrespectandconsiderationtoyourtherapistandothercustomerspleaseplanaccordingly
andbeontime.Ifyouarrivelate,yoursessionmaybeshortenedinordertoaccommodateothers
whoseappointmentsfollowyours.Dependsuponhowlateyouarrive,yourtherapistwill
determineifthereisenoughtimeremainingtostartatreatment.Regardlessofthelengthofthe
treatmentactuallygiven.Youwillberesponsibleforthe“full”session
HygieneConsiderations
WewillexpectourclientstoadheretotheutmostHygienestandardsaswedo.Weappreciateall
clientstobewellgroomed,bathedandcleanthusallowingourtherapisttoproperlyperformtheir
duties.
Ihaveread,understood,andagreedtothetermsabove.
Signature_____________________________________________________________________
Date___________________
Parent/GuardianSignature(ifapplicable)
______________________________________________
Date___________________