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Massage Waiver

1. Purpose of Massage

I understand that massage therapy is intended to promote relaxation, reduce stress, and support overall well-being. Massage therapists do not diagnose medical conditions, prescribe medications, or perform spinal manipulations.


2. Health Information

I confirm that the information I provide on my intake form is accurate and complete. I agree to update my therapist about any changes to my health, medications, or physical condition before each session.


3. Contraindications & Communication

I understand that certain medical conditions may prevent or limit massage therapy. It is my responsibility to inform my therapist of any conditions such as: cardiovascular issues, infections, injuries, skin conditions, recent surgeries, pregnancy, or other conditions that may affect treatment.

I agree to communicate immediately with my therapist if I experience discomfort, pain, dizziness, or any unusual sensations during the session.


4. Boundaries & Professional Conduct

I understand that massage therapy is strictly professional and non-sexual. Any inappropriate behavior may result in immediate termination of the session with full payment due.


5. Liability Release

I voluntarily choose to receive massage therapy from Calm Breath Wellness. I understand that while massage has many benefits, it also carries risks, including but not limited to: temporary soreness, skin irritation, bruising, or aggravation of existing conditions.

I release Calm Breath Wellness and its therapist from any liability for injury, discomfort, or damages that may result from massage therapy, except in cases of gross negligence.


6. Cancellation Policy

I understand that missed appointments or cancellations made with less than 24 hours’ notice may be subject to a cancellation fee.


7. Consent to Treatment

I understand the nature of massage therapy and give my consent to receive massage from the student practitioner for practice purposes. I acknowledge that this service is provided as part of training and may be supervised.


8. Signature

By signing below, I acknowledge that I have read, understood, and agree to the terms of this waiver.

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Massage Intake

General Information

Health History

Please check any conditions you currently have or have had:

Medications

Surgeries or Medical Procedures

Have you had any surgeries, procedures, or hospitalizations in the last 12 months?
Yes
No

Allergies & Sensitivities

Do you have any allergies (lotions, oils, scents, nuts, latex, etc.)?
Yes
No

Consent for Contact

Is it okay to follow up with you regarding future appointments or wellness offerings?
Yes
No

Additional Notes

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