Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I understand I may be asked for a referral from my primary care provider prior to service being rendered if determined necessary by my therapist.
I realize it is my choice to receive massage therapy. I acknowledge that the treatment is being given for the well-being of my body and mind. This includes stress reduction, relief from muscular tension, spasm or pain, increasing circulation, energy or lymphatic flow, or increasing mobility.
I understand that massage practitioners do not diagnose illness, disease, or any physical or mental disorder, nor do they prescribe medical treatment, pharmaceuticals, or perform spinal thrust manipulations.