Medical History: If you have experienced any of the symptoms that is marked with an asterisk (*), please call Kelli to discuss your medical history before booking an appointment; this is to ensure your safety and well-being. 

Cancellation Policies   100% Full Payment is required for a  No Show: If you do not show up for an appointment, you will be charged the full cost for the appointment.  

Late Arrival: If you are late to your session you are welcome to receive whatever time is left in your appointment. Due to our tightly booked schedule we are generally unable to extend your session beyond your original appointment time. Regardless of the length of the service actually given, you will be responsible for payment of the full service you scheduled. Please plan to arrive 10 minutes early for your appointment.  

50% Payment is required for the following condition:  Last-Minute Cancellation/Reschedule: Failure to cancel or reschedule your appointment at least 24 hours in advance will result in a charge of 50% of the scheduled appointment fee. 

Sickness Policy Please reschedule your appointment as soon as you are aware of an infectious or contagious condition.  If you arrive for your appointment with symptoms of an illness, you will kindly be asked to reschedule your appointment to avoid the spread of germs. This protects are most susceptible loved ones - children, the elderly, & people with suppressed immune systems, like cancer patients.  If any of the following describes you, I kindly ask that you reschedule your appointment so we can prevent the spread of bugs:  Fever or Chills Vomiting or Diarrhea  Runny Nose  Sore Throat or Cough You are currently taking an antibiotic.  You have a skin infection like ringworm or athletes foot.  You or someone in your direct care has a cold, sinus infection, flu bug, or the Corona Virus. You or someone in your direct care has been diagnosed with influenza (the flu). Even if you are cancelling your appointment within the 24-hour notice period, the cancellation fee may be waived; the onset of symptoms doesn't always have great timing, right?

Massage Policies:

Client services and chart information are confidential. Written authorization is required from you to release any information.

       • Please turn off your cell phone for optimal relaxation

       • Your scheduled session is set aside for you. We do not double book appointments

       • Please reschedule your session if you are more than 15 minutes late

       • 24 hour cancellation notice is required to avoid being charged for your session

       • You will be draped and at no time will genitalia or breast tissue be exposed

       • You will have a consultation with your therapist to discuss your session

       • Should the session require, after your therapist has left the room, you may disrobe to your  comfort level

       • I understand that my therapeutic massage therapist or I may end the session at any time for any reason

       • Inappropriate behavior will not be tolerated and may be prosecuted to the full extent of the law

Client Agreement:

I understand that therapeutic massage therapists do not diagnose illness, disease, any physical or mental disorder, nor do they prescribe medical treatment, pharmaceuticals, or perform joint mobilization.

I acknowledge that massage therapy is not a substitute for medical examination or diagnosis, and it is recommended that a physician be seen for that service.

It is my choice to receive therapeutic massage as a form of therapy.

I understand that treatment given is designed to address the care and prevention of myofascial pain and dysfunction.

I also undersand that at any time I feel pain or discomfort during the session, I will immediately inform my therapeutic massage therapist so they adjust. 

I have stated my pertinent medical conditions, and will update the massage therapist of any changes in my health status.

I understand that my failure to do so may post a threat to my health and/physical well being and I hold harmless Pure Touch Therapy and my therapeutic massage therapist from any liability whatsoever arising from failure on my part.

By typing my first name, last name, and providing my e-signature below, I am indicating the following:  1. I have read the New Client Intake Form for Soul Rejuvenation in its entirety.  2. I fully understand all questions and information provided in the New Client Intake Form for Soul Rejuvenation   3. I have completed the New Client Intake Form for Soul Rejuvenation accurately and to the best of my knowledge.