I Agree to the Above Terms *

PolicieS: Cancellation and Missed Appointment Policy: 24 hours advance notice is required when canceling an appointment. Any cancellation with less than 24 hours notice will be responsible for full payment. This amount must be paid prior to your next scheduled appointment. With short notice it is often difficult or impossible to fill an open appointment and there are others waiting to get in. Thank you for your understanding and consideration Missed appointments will result in a charge for the full amount due prior to the next scheduled appointment. Late Arrival Policy: Appointment times have been arranged in advance specifically for you.  If you arrive late and I have the time before my next session I will make every attempt to make up the time lost.  Depending on the length of lateness I may not always be able to make up the time lost.  Regardless of the length of treatment given, you will be responsible for the cost of the Full Session. Please plan accordingly and be on time. Payments: Payment is always expected at time of service. Accepted forms of payment are cash, check, Venmo, PayPal Credit cards are currently not accepted.

YES

No

Name *

First Name

Last Name

I understand that massage therapy is provided for stress reduction, pain relief, relief from muscular tension, improvement of circulation and relaxation. *

I Agree

If I experience pain or discomfort during the session, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort. I will not hold my therapist responsible for any pain or discomfort I experience during or after the session. *

I Agree

I understand that the services offered are not a substitute for medical care. *

I Agree

I affirm that I have notified my therapist of all known medical conditions and injuries. *

I Agree

I agree to inform my therapist of any changes in my health and medical condition. I understand that there shall be no liability on the therapist’s part should I forget to do so. *

I Agree

I understand that massage in entirely therapeutic and non-sexual in nature. *

I Agree

Name *

First Name

Last Name