| Pregnancy
Massage Information and Informed Consent
Massage during pregnancy provides many benefits. It enhances
circulation, supporting the work of your heart, and increasing
the oxygen and nutrients delivered to your baby. It can relieve
the sensation of heaviness and aching in your legs caused
by swelling or varicose veins. It can optimize your muscle
tone and function, relieve muscle strain and fatigue, and
reduce strain on your joints. Pregnancy massage reduces stress
and promotes relaxation, contributing to a healthier pregnancy.
If you have been told that your pregnancy is high risk, please
notify the therapist.
Please read and sign the acknowledgment below:
I have received and read written information concerning the
possible benefits of massage therapy during pregnancy. I verify
that I am experiencing a low risk pregnancy, and I have stated
all my known medical conditions. I understand that I will
be receiving massage therapy for the purpose of stress reduction,
relief from muscle tension or spasm, or for increasing circulation
and energy flow. I understand that the massage therapist does
not diagnose illness, and, as such, the massage therapist
does not prescribe medical treatment or pharmaceuticals, nor
does she perform spinal manipulations. I am aware that this
massage is not a substitute for medical examination or diagnosis,
and that it is recommended that I see a physician for any
ailment I might have. I understand and agree that I am receiving
massage therapy entirely at my own risk. In the event that
I become injured either directly or indirectly as a result,
in whole or in part, of the aforesaid massage therapy I HEREBY
HOLD HARMLESS AND INDEMNIFY the therapist, her principals,
and agents from all claims and liability whatsoever.
Signature _______________________________ Date _______________
Print Name __________________________________________________
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