Clients are expected to agree to and sign consent to the following policies upon intake of the first session during completion of examination paperwork:
I hereby state that, to the best of my knowledge, my answers to the above questions are correct.
I agree and consent to assessment and treatment. I understand that my personal health information will be collected. I understand that all information that I provide will be kept confidential unless required by law. I understand and consent that my medical information may be shared by the various care providers involved in my care and treatment.
I understand that massage therapy is not a substitute for medical examination or diagnosis. It is recommended that I see a physician for any physical ailment that I may have. I understand that licensed massage therapists do not prescribe medical treatments or pharmaceuticals and do not perform any spinal adjustments. I am aware that if I have any serious medical diagnosis, I must provide a physician’s written consent prior to services.
Treatments may be covered by extended health care plans. I understand that it is my responsibility to confirm the exact details of my coverage. I understand that this business does not work directly with insurance companies. I understand that it is my responsibility to collect an invoice, which can be provided upon request by this business, and file for coverage and reimbursement myself. I understand that Connor Dent, LMT cannot guarantee that I will be reimbursed or covered by my insurance plan.
I understand that sexual interaction or discussion of any kind between the client and the massage practitioner is never appropriate. If the practitioner feels that this line has been crossed, they will terminate the session immediately. The client will be charged the full amount. All clients are empowered with the same right and freedom.
It is the utmost concern that all clients feel safe and secure. I understand that the practitioner shall drape the breasts of all female clients and not engage in breast massage of female clients. I understand that draping of the genital area and gluteal cleavage will be used at all times during the session for all clients. I understand that, if uncomfortable for any reason, I may ask the practitioner to cease the massage and the practitioner will end the massage session.