I understand that massage therapy involves the manipulation of soft tissue and that there may be risks involved. I acknowledge that I have received a copy of the clinic's massage therapy policies and procedures, and I agree to comply with them.
I understand that my child will be draped with a sheet or blanket during the massage therapy session and that the massage therapist will only uncover the body part being worked on. If at any time my child feels uncomfortable, he/she will inform the massage therapist immediately.
I understand that my child may request to end the massage therapy session at any time, for any reason, and that the massage therapist will honor this request.
I understand that the massage therapist will maintain confidentiality regarding my child’s personal and medical information, except as required by law.
I acknowledge that the massage therapist is not a licensed medical professional and cannot diagnose, prescribe, or treat any medical condition.
I understand that payment for the massage therapy session is my responsibility.
I have read and understood the above information, and I give my consent for my child to receive massage therapy services at the above-mentioned clinic.