I hereby consent to a consultation and/or therapeutic treatment inluding but not limited to postural analysis, chair massage, and/or the use of kinesiology tape. These treatments may lead to tenderness. I will ask my practitioner for further details about these if required.

Mirage Bodywork respects your privacy, and never shares information. I understand and accept these terms, and give Mirage Bodywork LLC permission to possess my above information, and to treatment my body therapeutically.