I understand that massage therapy and bodywork are for the purposes of stress reduction, relief from muscular tension and spasm, general relaxation, and improvement of circulation and energy flow.

I understand that the bodywork practitioner does not diagnose illness, disease, or any other physical or mental disorder. The practitioner does not prescribe medical treatment of pharmaceuticals, nor does he/she perform any spinal manipulations. It has been made very clear that massage therapy and bodywork are not substitutes for medical examination or diagnosis and that it is recommended that I see a medical practitioner for any physical ailment that I may have.

I understand that services offered today, and in the future, are not a substitute for medical care and that any information provided by the therapist is for educational purposes only, and is not diagnostically prescriptive in nature.

I have stated all of my known medical conditions on the Intake Form. I have consulted a medical doctor or licensed medical health care practitioner regarding these conditions.

I realize it is solely my responsibility to keep the bodywork practitioner updated on any changes in my physical health and I understand that ________________ and the practitioner shall not be liable should I fail to do so.

I agree to actively participate, as much as possible, in my own healing and health maintenance.

I understand that all massage therapy and bodywork offered is strictly non-sexual

By signing this release, I hereby waive and release from any and all liability, past, present, and future, relating to massage therapy and bodywork.

I have received the policy statement, and have read and agree to the policies therein.