top of page

Informed consent


  • I have had a thorough consultation with my chosen practitioner

  • I have been informed of the proposed treatment plan and agree to proceed with my therapist to address my specific needs.

  • I understand that therapeutic massage is not a substitute for traditional medical treatment.

  • I understand the importance of informing my massage 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 considerations based on my physical/emotional/psychological condition.

  • I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during the massage session so he/she may adjust accordingly. 

GDPR May 2018:

The data collected on this form will be used for the sole purpose of clinical massage and will not be disclosed to any external sources. For insurance purposes, these records shall be kept for at least 7 years following the last occasion on which treatment was given.

bottom of page