New Client Intake & Waiver

Please check all that apply, now or in the past:

Massage may need to be postponed or modified if you have a fever, contagious illness, recent blood clot, uncontrolled high blood pressure, acute injury or inflammation, recent surgery, or are under the influence of alcohol or drugs. Hot stone work is not advised with diabetes-related neuropathy, pregnancy, or heat sensitivity. If unsure, please ask your physician before your session.

Preferred pressure:

You will be professionally draped with a sheet at all times; only the area being worked on is uncovered. You may undress to your comfort level and remain partially or fully clothed. You may ask to change pressure, stop any technique, or end the session at any time. Sessions are strictly therapeutic; any sexual or inappropriate comments or behavior will end the session immediately, with full payment due.

I understand that massage therapy is for relaxation and the relief of muscular tension, and is not a substitute for medical examination, diagnosis or treatment. The therapist does not diagnose illness, prescribe medication or perform spinal manipulation. I have stated all known medical conditions and will update the therapist of any changes. I understand that mild soreness can occur after deep work. I voluntarily assume the risks of massage therapy and release Return to Center LLC and Andy Leon, LMT from liability for any injury arising from undisclosed conditions or from following my instructions, except in cases of gross negligence. I consent to receive massage therapy.