Consent for Reflexology Session with Susan Lilley:
This is to acknowledge my wish to consent to receive reflexology, as outlined to me. I understand that I may withdraw consent at any time and that treatment will then be stopped. Reflexologists DO NOT diagnose, prescribe medication for medical or psychological conditions, or treat for specific conditions.
The information contained on this form is true to the best of my knowledge. I understand and accept that the sessions received are therapeutic value only and fully accept responsibility for the same.