• Personal Information

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  • Medical Information

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  • Medical History

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  • Disclosures and Agreements

    Please read and agree to the following disclosures and agreements below. To signify your acceptance, select "I AGREE" and hit "SUBMIT FORM" below.

  • I understand that the massage/bodywork I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during any session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort.

    I further understand that massage or bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment, and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware.

    I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session should be construed as such.

    Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner's part should I fail to do so.

    I also understand that any illicit or sexual suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment.

    I, the undersigned applicant, for an in consideration of the benefit to be derived by participation in this program release its agents, representatives, and staff from any and all liability and responsibility for injury, illness, sickness or death which may result from participation in the Pilates classes or programs elected, and do hereby further agree to indemnify and hold Metamorphosis Pilates & Bodywork, Inc., its agents, representatives and employees from any and all liabilities in such regard.

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