Client Consent Form

Please read the following information carefully and submit the form below.

Client is responsible for talking to a physician before receiving a massage and informing the therapist of any medical conditions, including but not limited to: heart conditions, STDs, asthma, eczema, skin disease, transplants, joint replacements, scoliosis, cancer, pregnancy, cosmetic surgery, and COVID.

Massage affects each individual differently. The client should communicate with the therapist before, during, and after each massage:

What do you expect from the massage
Any new medical conditions?
If pressure is too much, not enough.
Any area that needs more or less attention.
Schedule another appointment.

After treatment, be sure to drink plenty of water to stay hydrated and flush out toxins.

The client or the therapist has the right to end a session at any time for any reason.

By submitting the information below, the client or legal guardian assumes all responsibility: Understands there are risks such as, but not limited to, soreness, bruising, dislodgement of blood clots, nerve injury, bone fracture, complications with pregnancy. Please do not endure too much pain, as it may do more damage to underlying conditions. Make sure to communicate any concerns before, during, and after each massage.
This includes receiving a massage by Amber Snyder LMT, now and in the future.

Please fill out the client consent form below.

Client Consent Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Birthday *

Please list any medical conditions you have. *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

By submitting the information above the client or legal guardian assumes all responsibility for receiving a massage by Amber Snyder LMT now and in the future and the client acknowledges risks of getting a massage.

All clients under age 18 must obtain parental consent prior to scheduling an appointment.

Submit