By SUBMITTING THIS FORM, you agree to the following:
1) I give my permission to receive massage, facials or waxing services.
2) I understand that therapeutic massage is not a substitute for traditional medical
treatment or medications.
3) I understand that the therapist or esthetician does not diagnose illnesses or injuries,
or prescribe medications.
4) I have clearance from my physician to receive facials and massage therapy.
5) I understand the risks associated with massage therapy, facials, and waxing include, but are not limited to:
• Superficial bruising or redness
• Short-term muscle soreness
• Exacerbation of undiscovered injury
I, therefore, release Touch For Life Wellness and the individual therapist or esthetician from all liability concerning these injuries that may occur during the massage session.
6) I understand the importance of informing my therapist of all medical
conditions and medications I am taking, and to let the massage therapist know
about any changes to these. I understand that there may be additional risks
based on my physical condition.
7) I understand that it is my responsibility to inform my therapist or esthetician of any
discomfort I may feel during the session so he/she may adjust
8) I understand that I or the therapist may terminate the session at any
9) I have been given a chance to ask questions about the session
and my questions have been answered.