Thank you! ありがとうございます！
Client information are confidential and written authorization is required to release any information.
Massage and bodywork therapy practices are designed to promote and maintain the healthand well-being of the client.
Massage and bodywork therapies do not include the diagnosis ofillness, disease, impairment or disability.
If I experience any pain or discomfort during thissession, I will immediately inform the therapist so that the pressure and/or manipulations may beadjusted to my level of comfort.
Because massage and bodywork therapy may becontraindicated due to certain medical conditions, I affirm that I have informed the therapist of allmy known medical conditions and will keep the therapist updated as to any changes in mymedical condition.
By my electronic signature below, I agree to the massage policy and client agreement above.
Herbal Steam Guidelines● Please bathe or take shower in the morning of the treatment or the night before.● Please notify us if you have any food allergies including gramineous plants for the sake of safeherbal steam● Please seek immediate attention if the temperature of the steam is too hot causing anydiscomfort.● Please keep yourself hydrated before, during, and after the treatment. Herbal tea will be providedduring the session and a non dairy probiotic drink afterwards.● Do not use drugs, tobacco, or alcohol prior to or during the steam.● If you have a medical condition or are on any prescription medications, consult with yourphysician before getting the herbal steam treatment.Herbal Steam is Not for Those..● First trimester of pregnancy● With pregnancy toxemia● With urinary protein problems● Trying to get pregnant with IVF or ICSI method● With fever● Not recommended to bathe or use sauna by a physician
I acknowledge and accept the risks inherent in the use of the healing herbal steam. I voluntarily assumethe risk of injury, accident, or death, which may arise from the use of the healing herbal steam.
I and any of my heirs, executors’ representatives or assigns hereby release from all claims or liabilities for personal injury or property damages of any kind sustained while on the premises, during the use of the healing herbal steam and from any advice provided by an employee or any representative.
I agree that thisrelease is in effect for all healing herbal steam sessions.
None of the information provided is intended to act as a substitute for medical advice, nor does it involvethe diagnosis, prognosis, or prescription of remedies for the treatment or prevention of any disease orailment.
I certify that everything on this form is true and correct to the best of my knowledge.
I also understand thatthe healing herbal steam is not intended to diagnose, treat, cure, or prevent any disease or ailment.