Consent & Agreement

I understand that the massage, bodywork and any other service I receive is provided for the purpose of stress reduction, relief of muscular tension, spasm, pain, to increase circulation and general wellbeing. If I experience any pain, discomfort or any other negative reactions beyond my comfort level, I will immediately inform the therapist so that it may be addressed, adjusted or stopped. I understand that massage and bodywork therapists do not diagnose disease, nor do they perform spinal manipulations or prescribe any medical treatments, and nothing said or done during the session should be construed as such. I acknowledge that massage and bodywork is not a substitute for any medical services. Because massage and bodywork should not be performed under some circumstances, I affirm that I have stated all known medical conditions and agree to keep the therapist updated as to any changes in my health, and I release the therapist and East West Tantra clinic from any liability if I fail to do so. Please sign the form below before your appointment or class.

Consent Form

Have you been hospitalized or had a surgery in the last 6 weeks?
Are you currently suffering from a medical condition, illness, injury or have allergies we should be aware of?
To your knowledge, have you been exposed to COVID-19 or had any COVID-19 related symptoms in the last 14 days?

© 2019 by Carl Jordan, LMT. Lic: MA31775, MM36906

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