Please check any that apply:

I understand Kobido Japanese Facial Massage is a non-medical wellness treatment intended to promote relaxation, improve circulation, reduce muscle tension and support skin wellness. It is not a substitute for medical care. I agree to inform my practitioner of any changes to my health before each treatment. I understand temporary redness, tenderness or sensitivity may occur, and I may stop treatment at any time.

I confirm I have disclosed all relevant medical conditions, medications, cosmetic procedures and skin sensitivities. I understand treatment may be modified, postponed or declined if it is not considered safe.

My personal and health information will remain confidential and used only to provide safe treatment, except where required by law.

I voluntarily consent to receive Kobido Japanese Facial Massage. I have read and understood this form, had the opportunity to ask questions, and certify that the information provided is complete and accurate to the best of my knowledge.