By signing this form, you agree to the following:
- I voluntarily request and consent to receiving Assisted Stretching Therapy.
- I understand that the Assisted Stretching service offered is for the therapeutic purpose of general wellness, improved range of motion, stress reduction, and relief of muscular tension.
- Information about Assisted Stretching, potential benefits, effects, risks, contraindications, and possible alternative therapies have been explained to me and I understand this information.
- I understand the risks associated with Assisted Stretching Therapy include, but are not limited to: Short-term muscle soreness and the exacerbation of undiscovered injury.
- I have been given the opportunity to ask questions about Assisted Stretching Therapy and my questions have been answered to my satisfaction.
- If I experience any pain or discomfort, I will immediately inform my Assisted Stretching Therapist so that the pressure or techniques can be adjusted to my comfort level.
- I will not hold my Assisted Stretching Therapist (Britain Schroeder, LMT LLC) responsible for any pain or discomfort I experience during or after the session.
- I have provided my Assisted Stretching Therapist with an accurate and complete medical history and agree to inform my therapist of any new diagnoses, or changes in my health or medications.
- I do not have any injuries or conditions that prevent me from receiving assisted stretching therapy. Injuries or conditions not suitable for Assisted Stretching Therapy include but are not limited to: recent fractures that are still healing, acute inflammation, active infections, tissue trauma such as hematomas, pain with joint movement, the presence of a bony block limiting joint motion, and joint hypermobility.
- I understand the importance of informing my Therapist of all medical conditions and medications that I am taking, and that there may be additional risks based on my physical condition.
- I understand that I or the Assisted Stretching Therapist may terminate the session at any time.
I further understand that Assisted Stretching Therapy is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware.
I understand that Assisted Stretching Therapists do not diagnose illness or disease, and nothing said during the treatment should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken.
By signing this form, I agree to the conditions as outlined above, and I release the Assisted Stretching Therapist and business (Britain Schroeder, LMT LLC) from all liability for any harm that may unintentionally result from this treatment.