CONSENT & WAIVER
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I understand that bodywork and yoga are for the purposes of stress reduction; relief from muscular tension, spasm, and pain; general relaxation; and for improvement of circulation and balance of energy flow.
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I understand that results will vary depending on the individual and the extent of his/her condition.
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I understand it is the client’s responsibility to notify the practitioner immediately if the client should feel their well-being is being compromised in any way.
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I understand that Thai Yoga Practitioners do not diagnose illness nor do they prescribe medical treatment.
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I understand that Thai Yoga Bodywork is not a substitute for medical examinations or diagnosis.
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I understand it is recommended that I see my primary health care provider for exams and diagnosis of ailments I may have.
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I understand the practitioner does not prescribe medical treatment nor does he/she perform any spinal manipulations.
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I understand that any information offered by the practitioner is for educational purposes only.
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I have consulted a medical doctor or licensed medical health care practitioner regarding any listed or described conditions.
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I have stated all of my known medical conditions on the form below, including any of the following:
Current/Recent Illness
Current/Recent Pregnancy
Muscle Strain/Sprain
Back/Neck Pain
Low/High Blood Pressure
Blood Clots/Heart Attack/Stroke
Arthritis/Osteoporosis
Chronic Illness
Allergies
Skin Infections or Diseases
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PLEASE SHOWER PRIOR TO SESSION
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PLEASE WEAR LONG SLEEVES AND PANTS, BRING OR WEAR SOCKS
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UPON ENTERING, PLEASE REMOVE SHOES, WASH HANDS
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MASKS ARE NOW OPTIONAL FOR CLIENT, MASK WILL BE WORN DURING YOUR SESSION BY PRACTITIONER
I realize it is solely my responsibility to provide updates to the practitioner. BY SUBMITTING THIS FORM (BELOW) I assume full responsibility for receipt of Thai yoga bodywork and release and discharge the practitioner from any and all claims and liability.
Photo Credits:
Kat Majestic KM Photography