• The Massage Negotiator Client Liability Form :

    Required by law to massage over the age of 18 (or with separate consent form for massage of a minor), keep progressive reports of clients, protect this information by HIPPA/HIPAA regulations, maintain these client details to prevent massage and bodywork contraindications. An assessment that fully details the modalities and services provided for that session, the appointment date, time of appointment, suggestions for maintaining health and wellness and for your next massage appointment are filled in by your massage therapist and emailed to you after every appointment in 0-7 days (not required by law). You must fill in a new form every 1-2 years for any unforeseen health conditions or limitations you might need to change for your subsequent massage sessions. All massage sessions are customizable and accommodating to any new changes you might experience. After filling out this form you will receive a copy at the email you provided for your records.
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  • Please read the following terms and conditions and sign your name after reading each item below about your massage session.

  • I understand that by purchasing a massage session from Janis Corona, LMT #18843, I am allowing said massage therapist to work on my body for the purchased amount of time in one of the modalities she is trained, educated, licensed, and insured to perform said modality service on my body. All laws and precautions common to the modality and my health condition as indicated below will be followed according to the state of California and the California Massage Therapy Council standards and practices for massage therapists operating in California.

    Only massage of those body parts uncovered and not including the genitalia, breasts, or the medial gluteal region along the sacrum (buttocks crack) will be performed. The abdomen will only be massaged if requested before the session for digestive or scar adhesion myofascial and/or lymph drainage methods, and the breasts will be covered for females as well as underwear will be worn by both genders. Draping protocols will be followed for heat sensitive patrons and only each body part worked on will be undraped and re-draped by linens when moving to the next body part, until the conclusion of the massage session.

    Prone (face down), supine (face up), and/or side lying massage positions will be used in the session, according to your pre-determined assessment and consultation.

    If I find other areas that are in pain, ache, tender, and/or need more or less time or pressure focusing on that area as it is encountered, I will notify the massage therapist at that time so that my massage session maximizes my expectations for this service and holds me free from complaining about my massage therapist not being able to intuitively know I want more pressure when my muscles spasm or contract with more or less pressure.

    I understand each client is unique in their associated pain, sensitivity, and patterns of aches and tension and do not expect my massage therapist to know exactly how I want these conditions addressed without me verbally explaining that I want more pressure, less pressure, some stretching, some heat, some cold, and so on applied to that area of my body.

    Any conversation or body language that can be understood to be sexually explicit or implied towards my massage therapist, violent towards my massage therapist, offensive towards my massage therapist, or socially and reasonably considered disrespectful towards my massage therapist is reason enough to have my massage session end and pay for the service will not be refunded.

    I understand that having a location with cell phone service and freedom to enjoy my massage in a peaceful environment I have arranged at my personal location is necessary to maximize the benefits from my massage session and will not schedule my massage session in an area without cell phone service, with people or pets that harass my massage therapist, and that this is reason to lose my deposit on the massage session if these requests are not honored.

    I understand that it is important to block from my schedule the right amount of time for each scheduled session and to be prompt in starting the massage session and ending the session so that the full amount of hands-on time for the massage is completed.

    The massage modalities that Janis Corona, LMT #18843 is licensed, educated, and trained to perform from school, franchise training, or continuing education are: Swedish, Swedish deep-tissue massage, Shiatsu massage, Sports massage, Lymphatic drainage massage, cranio-sacral massage, prenatal massage, myofascial massage, stretching, cupping, instrument assisted soft tissue mobilization tools (IASTM), kinesiology taping, hot stone therapy, cold stone therapy, aromatherapy, and trigger point therapy.

    I understand that light pressure, medium pressure, and deep pressure and firm pressure vary between massage therapists. Firm pressure is a more spread out pressure across more of the major muscles of my body, where as light pressure could be the similar but with less pressure applied. Deep massage is to reach the deeper adhesions between deeper layers of muscle and can be applied with smaller points like the thumbs and elbows, or with a very strong flat surface of the hand and forearm by the massage therapist. I will indicate during the massage if the pressure needs to be increased or reduced by my massage therapist and if I want a broader surface (palms and forearms) or smaller surface of application (knuckles, elbows, and fingers).

     

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  • Thank you for filling out your liability and consent to have massage therapy services by The Massage Negotiator. You can save the form now and email janis@themassagenegotiator.com a copy or continue filling out the optional customization of your first massage session on this form. You can also submit it as is if all required fields are filled in by clicking submit below.

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  • Customization of Massage Session for First Time Clients



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