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Please read and initial all the following statements.
  • If I experience pain or discomfort during the session, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort. I will not hold my therapist responsible for any pain or discomfort I experience during or after the session.

  •  I understand that the services offered are NOT a substitute for medical care. I understand that my therapist is not qualified to perform spinal or skeletal adjustments, diagnosis, prescribe or treat physical or mental illness

  • I agree to inform the therapist of any changes in my health and medical condition. I understand that there shall be no liability on the therapist’s part should I forget to do so.

  • I understand that massage is entirely therapeutic and non-sexual in nature.

  • By signing this release, I hereby waive and release my therapist from any and all liability, past, present and future relating to massage therapy and bodywork.

  • I understand that should I cancel an appointment less than 24 hours before the scheduled time or “no show” an appointment I am subject to a fee equal to the cost of the missed appointment.

  • I agree to make full payment for my session prior to scheduled appointment.

Information and Suggestions
  • Prior to your massage, please remove contact lenses and all jewellery. Pull long hair back with a clip or band.

  • Avoid eating a heavy meal 2 hours prior to appointment.

  • Please arrive clean and showered and any shaved areas of the body done so prior to appointment.

  • Massage is given while you are unclothed with the use of a modesty towel and sarong to cover areas not being massaged.

  • Client privacy and confidentiality will be maintained at all times.

I have received the policy statement and have read and agree to the policies therein.

Client Name:

Client Signature:


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