DISCLAIMER & CANCELLATION POLICIES

MASSAGE THERAPY INFORMED CONSENT & PAYMENT INFORMATION:

I understand that the massage/bodywork/release work I will receive is provided for the basic purpose of relief from stress and muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that pressure or strokes may be adjusted to my level of comfort. I further understand that massage/bodywork/release should not be considered a substitute for medical examination, diagnosis, or treatment and that I should see a physician or other qualified health care specialist for any mental or physical ailment of which I am aware. I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mentalillness, and that nothing said in the course of a session should be considered as such. 

Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and have answered all questions honestly. I agree to keep the practitioner informed of any changes to the above profile and understand that there shall be no liability on the practitioner‘s part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment for the full time scheduled. I agree to honor the 24-hour cancellation policy or else be responsible for payment of 50% of the appointment fee that would have been due.

The following sometimes occur during massage. They are normal responses to relaxation and/or touch, and need not be embarrassed nor suppress them. Movement or release of intestinal gas - crying - laughing - strong emotions - sighing - groaning - yawning - softening of muscle tissue - cognitive or felt memories - stomach gurgling - need to move or change position. At any time during your session please let me know if there is anything I can do to help you feel more comfortable.
 

I understand that the services provided are not a replacement for medical or psychological care and that any information provided is not prescriptive or diagnostic in nature and is for educational purposes only. I also give my permission for Casey Jindra to discuss information pertinent to my condition(s) and treatment, with my other health care providers and coaching staff - if need be.

I have provided all my known medical information. The general benefits of massage, possible massage contraindications, and the treatment procedure have been explained to me. I acknowledge that massage is not a substitute for medical diagnosis and treatment.

A referral from your primary care provider may be required prior to service being provided. I understand that the massage/bodywork I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage or bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment that I am aware of. I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session should be construed as such. Because massage/bodywork perform under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioners part should I forget to do so. It is also understood that any elicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment. 

Sorry, I am not accepting Personal Injury cases or Med Pay at the moment.

CANCELLATIONS & NO SHOWS: 

*PLEASE NOTE:  24 hour notice is required for cancellations, otherwise you will be charged an  LMC (last minute cancellation fee) = 50% of the booked session, for having reserved the time.

Payment

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