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If I experience pain or discomfort during the session, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort. I will not hold my therapist responsible for any pain or discomfort I experience during or after the session.
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I understand that the services offered are not a substitute for medical care. I understand that my therapist is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness.
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I affirm that I have notified my therapist of all known medical conditions and injuries.
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I agree to inform the therapist of any changes in my health and medical condition. I understand that there shall be no liability on the therapist’s part should I forget to do so.
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I understand the massage is entirely therapeutic and non-sexual in nature.
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I understand that I am receiving massage therapy at my own risk. In the event I become injured either directly or indirectly as a result, in whole or in part, by signing this release, I hereby waive and release my therapist from any and all liability, past, present, and future relating to massage therapy and bodywork.
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I understand that should I cancel and appointment less than 24 hours before the scheduled time or “no show” an appointment, I am subject to a fee equal to the cost of the missed appointment. This fee is monetary and cannot be taken as an additional “punch” off a massage package card. If the appointment was booked under a gift certificate, it will be voided in lieu of the fee.
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Electronic Signature Agreement: This service is provided to eliminate unnecessary use of paper. By typing in your name in the signature field, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. You consent to be legally bound by this Agreement's terms and conditions, acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and PureHealth4Life. You further agree that each use of your E-Signature in obtaining PureHealth4Life service constitutes your agreement to be bound by the terms and conditions of PureHealth4Life Polices, Procedures and Agreements as they exist on the date of your E-Signature
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I have received, acknowledged reading the Massage Client Waiver Form, and agree to the foregoing herein.
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