MASSAGE IS NOT RECOMENDED FOR: Anyone with the threat of miscarriage, premature labor, pre-eclampsia or eclampisa, active infection or infectious disease, nausea or vomiting, kidney / bladder disease, or blood clots.
Privacy/Confidentiality: The client understands that their personal health information and any other client records are maintained by the therapist are private and confidential. The client understands that their information will not be shared with any third party without prior written consent or a subpoena or court order.
Informed Consent: Aimeé at Seacoast Mother Nurture Massage will accept any low risk prenatal client at any stage of her pregnancy. Studies have shown that there is no correlation with first trimester massage and miscarriage. Hi-risk clients must have a signed note on file from their prenatal care provider clearing them for massage. By signing this form, you are verifying your good health and consent for massage (pregnant or not) at this time and with all consecutive sessions with Aimeé. If anything should change with my health, I will notify Aimeé at the time of my appointment.
Covid Waiver / Consent: Please ask yourself the following questions. Have you had a fever in the last 24 hours of 100 degrees or above? Do you now, or have you recently had any respiratory or flu symptoms, sore throat or shortness of breath or rash? Have you been in contact with anyone in the last 14 days who has been diagnosed with Covid-19 or has covid symptoms? If an answer is yes, please contact me so we can reschedule you.
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, inluding covid-19. By signing this form, I acknowledge that I am aware of the risks invloved with receiving treatment at this time and for all consecutive massage sessions with Aimee, I voluntarily agree to assume those risks and I release and hold harmless the practioner/business from any claims related thereto. I give my consent to receive treatment from this practioner.
*I agree as your therapist that I will abide by the same standards and affirm the same. -Aimee Caruso
Cancellation Policy: If you need to cancel, I kindly ask that you so within 24 hours before your scheduled appointment. My time is valuable and I can’t always fill an empty appointment immediately which is a huge loss for me. There will be a 50% cancellation fee for any massage sessions cancelled within the 24-hour time frame. If you don't show up for your appointment or are more than 15 minutes late for your scheduled time, you will be considered “no show”. You will be required to pay the full amount of your session for a no show. Please respect my time as much as I respect yours. An emergency is always an exception. I appreciate your understanding.
Minor Consent (if applicable): By signing below, you agree that you are the parent or legal guardian of the minor receiving massage and that you give permission for your child to receive massage and agree to all the following terms. You understand that you are required to remain in the office during entirety of the minor’s massage. You or the minor may also request that a parent remain in the room if they wish. You also agree that you have completed the Intake Form and have informed the therapist of all medical diagnoses, symptoms, medications, and complaints associated with the minor receiving massage.