Member Update Form – Body First

Your Treatment-Consent

Please take a moment to read and agree the following statements regarding your treatment. By checking the boxes your are hereby affirming that you have read, fully understand and therefore consent to participating with Body First in programs and services within the framework stated below and in Body First's Privacy Policy

Privacy Policy*

I agree to the privacy policy.*

Body First Policy Privacy

Scheduling and Cancellation Policies*

I agree to the Scheduling and Cancellation Policies.*

Body First Policy Privacy

Massage Therapy for wellness*

I understand that the services I receive is provided for the purpose of wellness and body maintenance and services may include modalities that are designed to enhance physical fitness, mental attitudes, and alertness.

Client Health Warranty*

I am not aware of any disability, impairment, or ailment preventing me from receiving massage therapy. I affirm that I have stated all my known medical conditions and injuries and answered all questions honestly. I agree to keep the massage therapists updated as to any changes in my health profile, and understand that there shall not be liability on the massage therapist’s part should I forget to do so.

Massage Therapist role in client wellness.*

I understand that massage therapists are not qualified to diagnose or prescribe for disease conditions and that nothing said, done, performed, typed, printed or produced is intended or meant to diagnose, prescribe, treat a disease or takes the place of a licensed physician, chiropractor, registered dietitian or other qualified health professional. I understand that body maintenance assessments and suggestions are intended only for the support of optimal health and do not involve diagnosing, prognosticating or prescribing any remedies for the treatment of disease conditions.

Client responsibility for their wellness*

I understand that I accept total responsibility for my own health care and maintenance and that I should seek treatment from a physician, chiropractor, registered dietitian or other qualified medical specialist for any medical conditions that I am aware of.

Clients right to manage their massage therapy session*

. I understand that I accept total responsibility for my own health care and maintenance and that I should seek treatment from a physician, chiropractor, registered dietitian or other qualified medical specialist for any medical conditions that I am aware of.

Therapist’s right to refuse service.*

I understand that the therapist may choose to end any massage therapy session if they believe massage therapy could be detrimental to the client, the client is under the influence of drugs or alcohol, or the client exhibits any inappropriate behavior towards the therapist.

Professional Draping*

For all services that require the client to undress; professional draping will be used during the session.

Massage Therapy Client Intake Form

Step 1 of 5

EMAIL

Massage Therapy Information

Health History

Your Treatment-Consent