Client services and chart information are confidential. Written authorization is required from you to release any information.
• Your scheduled session is set aside for you.
• 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
• All sessions are completed with the client wearing comfortable clothing such as shorts, tank top, or
sports bra. If the client requests to be undressed, then proper draping will be used.
• Breast massage is not performed at Dynamism Manual Therapy.
• 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
I understand that all massage techniques (deep tissue, swedish, neuromuscular, etc.) scientifically have the same outcomes and will only provide short term relief and will not change or alter any musculoskeletal structures. Therefore, pressure is the only concern and will be dictated by the clients threshold of pain.
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 I will be asked to perform corrective exercises specifically designed to the issues I present on the day of my session.
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 Dynamism Manual Therapy and my therapeutic massage therapist from any liability whatsoever arising from failure on my part.
By my electronic signature below, I agree to the massage policy and client agreement above.
(Parent or Guardian if under the age of 17)