• MASSAGE INTAKE FORM

    All information is confidential. At no given point is information disclosed or shared without your written consent.
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  • Health Information

  • PLEASE READ THE FOLLOWING STATEMENTS THEN SIGN BELOW

    I understand massage treatments given at Decompressed by KJ are for the sole purpose of stress reduction, relief from muscle tension or spasm, and to increase circulation and blood flow. Therapists do not diagnose or prescribe for medical illness, disease, or any other physical or mental disorder. Nothing said during the session should be construed as such. Therapists do not conduct spinal manipulations. Massage therapy is not a substitute for medical examination or diagnosis, and it is recommended that a physician be seen for any ailments you may have. Because massage should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions to the best of my ability.

    Breast massage is not allowed. Breasts will be covered at all times. Draping will always securely cover the genital area and gluteal cleft. Depending on your specific need, the therapist can work the glute area with your permission. 


    I am aware that draping will be used during the massage session and that it is not within the scope of work, and that it is prohibited, for therapist to engage in a breast or groin massage. I understand that the session is not sexual in any manner and that any sexually suggestive remarks or advances made by me will result in immediate termination of the session. I understand that if at any time I have concerns about techniques or experience any discomfort, I am to alert the therapist; and, that I may terminate the session at any time.


    CLIENT/GUEST CONDUCT POLICY

    Decompressed by KJ is committed to providing the safest work environment possible. Mutual respect, courtesy and professionalism is expected between guests and team members at all times. Conduct by guests that violates this Guest Conduct Policy or is otherwise inappropriate or illegal will not be tolerated at any Decompressed by KJ facility. In instances of Guest misconduct, team members have the right to make themselves safe, remove themselves from the situation, and take all available steps to report the incident to the proper authorities. 

    Decompressed by KJ has zero tolerance for Guest misconduct, including, but not limited to:

    Contact or Communication that is Sexual in Nature

    Guests may only engage in acts for the sole purpose of receiving massage services. Contact that is sexually suggestive, sexual in nature, or not appropriate for a spa setting is not tolerated by Guests. Guest misconduct includes:


    1. A Guest using language or engaging in communication with team members that is sexual in nature, including making sexually suggestive remarks or advances to a team member, using language that implicitly refers to sex, sexuality, the physical appearance of a team member in a sexual manner, or the solicitation of a team member for intimate purposes.
    2. A Guest requesting a team member to touch or massage their genitals, breasts, or gluteal cleft, or requesting a team member to engage in any act that is sexual in nature.
    3. Guest-initiated contact of a team member’s genitals, breasts, glutes, or any physical contact that is of a perceived sexual nature, including kissing.
    4. A Guest intentionally exposing their genitals, breasts, or gluteal cleft to a team member, including dressing, or undressing in-front of a team or removing draping from these areas.
    5. Any instance of a Guest rubbing their genitals, breasts, or gluteal cleft or rubbing their genitals, breasts, or gluteal cleft on any other object or person with the intent of sexual stimulation.
    6. Guest-initiated communication with a team member via phone, text, email, or social media that implicitly or explicitly refers to sex, sexuality, the physical appearance of a team member in a sexual manner, or the solicitation of a team member for intimate purposes.

     

    Abusive, Violent, or Threatening Behavior

    Guests must refrain from engaging in acts of violence against, threatening harm to, and communicating or acting in an abusive way towards a team member. I have read and fully understand this form in its entirety. If at any time there are changes to the information given, or in my condition, I will notify my therapist, and update this form before receiving additional services.

    In signing this consent for treatment and waiver of liability, I understand and agree that this consent and waiver will apply to the current massage session and all future massage sessions performed by the therapist and/or performed at any Decompressed by KJ facility.

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