Buccal Massage Consent Form

One component of The Signature Face Sculpting Massage integrates the innovative Buccal Massage technique. This involves working on both the exterior of the face and internally through the mouth, allowing access to deeper layers of muscle tissue. The outcome is a natural face-lift effect without the need for surgical interventions. Offering it to individuals aiming to naturally enhance and preserve the beauty, health, and radiance of their skin.

Helps remove tension and stress in the muscles Improves muscle tone Reduces the appearance of wrinkles Improves facial contour Reduces swelling and dark circles under the eyes Improve skin's texture Helps release psychoemotional blockages often associated with everyday stress

Releases tension associated with TMJ Syndrome

Please check any of the following conditions that may apply to you:

Active severe or Cystic facial acne Open facial wound or lesion

Metal stents in treatment area

Implanted electrical devices Pregnant or lactating Migraines Bell's Palsy

Presence of bruises Febrile conditions accompanied by an increase in body temperature Burns, abrasions, wounds

Skin infections Autoimmune disease

It is advisable to undergo a series of facial massage sessions for optimal outcomes. The precise number of sessions will be determined during the initial visit, considering your skin's specific condition and characteristics. To maintain the benefits gained from the treatment course, engaging in facial massage periodically throughout the year is recommended, complemented by a personally tailored therapeutic regimen of cosmetic products.

By endorsing this document, you acknowledge and agree to the following terms: 1. I grant permission to undergo massage therapy. 2. I understand that buccal massage is not a replacement for conventional medical treatments or medications. 3. I acknowledge that the massage therapist does not diagnose illnesses or injuries or prescribe

4. I have obtained clearance from my physician to undergo massage therapy. 5. I am aware of the potential risks associated with massage therapy, including, but not limited

Exacerbation of undiscovered injuries

As such, I release the company and the individual massage therapist from any liability related to injuries that may occur during the massage session.

I acknowledge the importance of disclosing all medical conditions and medications to my massage therapist and informing them of any changes. I understand that additional risks may arise based on my physical condition.

I take responsibility for communicating any discomfort experienced during the massage session SO that adjustments can be made accordingly.

I acknowledge that either I or the massage therapist may terminate the session at any time. I have had the opportunity to seek clarification by asking questions about the massage therapy sessions, and my inquiries have been adequately addressed.