Client Intake Form All information is held strictest confidence. At no given point is information disclosed or shared without client’s written consent.
Policies
If I am not able to make a scheduled appointment, I agree to cancel or reschedule the appointment at least 24 hours in advance. I agree to pay for the full session rate with a card on file if I give less than 24 hours’ notice.Initial* I understand I must arrive on time for my appointment in order to get the full session time I have scheduled. If I arrive late, I understand the therapist can only give me whatever time remains of my appointment, and that I will pay for the full length of the session that I booked.initial*
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. initial * I understand that the services offered today are not a substitute for medical care. I understand that my therapist is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness. I have notified my therapist of all known medical conditions and injuries and I agree to inform the 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. Initial*
I understand that massage is entirely therapeutic and non-sexual in nature. 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. I hold harmless Finger Lakes Massage Therapy and my therapeutic massage therapist from any liability whatsoever arising from failure on my part.initial *