Relaxation Massage Intake Form

I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform Melissa so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage should not be construed as a substitute for medical examination, diagnosis, or treatment. I understand that Melissa is not qualified to perform skeletal adjustments, diagnose, prescribe or treat any physical or mental illness, and that nothing said in the course of this session given should be construed as such. Because massage should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep Melissa updated as to any changes in my medical profile and understand that there shall be no liability on Melissa Gardiner’s part should I fail to do so.