If I am currently having or develop complications (any conditions/symptoms listed above with *) I will discuss the condition with my massage therapist and will have a medical release for bodywork signed by my prenatal care provider before continuing bodywork
I have completed this health form to the best of my knowledge. I understand that Bodywork is a health aid and does not take the place of a physicians care. Any information exchanged during Massage or Bodywork session is confidential and is only used to provide you with the best health care services.
If I am not able to make a scheduled appointment, I agree to cancel the appointment 24 hours in advance. If I miss a scheduled appointment without giving 24 hours notice, I agree to pay any missed appointment charge.
I am responsible to pay for any Massage or Bodywork fees not paid for by my insurance company.