Event Chair Massage Intake

Please read before submitting:

I understand in signing the above that: Massage therapy (Which may include styles of: Chair, Swedish, Sports, or Deep Massage) involves neither diagnosis nor treatment of any condition and is not a substitute for medical care. I will be clothed during this session. This is not a full-body massage, neither breasts nor genitalia will be massaged.

If I am uncomfortable for any reason I may request to end the session and it will end promptly.

If the client is under the age of 17, written consent from the client’s guardian or parent is required.

I affirm that I am able to receive Massage Therapy and that any of the information I have provided above does not prohibit me from doing so. I am aware that if I have a medical diagnosis that prohibits me from receiving a Massage I must provide a physician's written consent prior to services.