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  • English (US)
  • Covid-19 Information and Liability Waiver

    For Rebecca Brancheau Massage and Creekside Wellness Center
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  • Please Select a "No" or "Yes" answer:

  • Consent for Treatment

    I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19.

    By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto.

    I give my consent to receive treatment from this practitioner.

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