Physiotherapy treatments may consist of different techniques such as manual therapy, spinal manipulation, electrotherapy, acupuncture, and exercise, which may be recommended as part of your program. The physiotherapy studio has a policy where your therapist will explain the benefits, potential side effects, and risks associated with each technique. If you have any concerns or questions during the program, you should inform your therapist so that necessary adjustments can be made. Your active participation is crucial for the program's success, and if you choose not to participate, you should inform your therapist immediately.
I, First Name Last Name acknowledge and accept the policy mentioned above. I consent to take part in the evaluation and treatment program as outlined. I am aware that I have the option to revoke. my consent at any point in time.Signed Date: Date Signature: Signature