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Thai Smile Client Consent Form

 

 


​Client Consent

​I, ___________________________________ here by consent for Thai Smile to provide me with massage treatments.

I acknowledge and fully understand the Thai Smile does not employ medical professionals and that the masseuse is not a medical professional.  Thai smile is not responsible for providing diagnosis for any illness, physical disorder or mental disorder.  

I understand that while massage can provide many benefits to good health, it is not a medical treatment.  I understand that I must attend my personal physician for treatment of any ailments, injuries or illness that I may be experiencing.

I acknowledge that it is my personal responsibility to ensure that Thai Smile is aware of any medical condition, illness or injury that may impact my ability to receive massage treatments.  I further acknowledge that it is my responsibility to keep Thai Smile updated on any changes to my health that may affect my ability to receive massage treatments.

I acknowledge that I have had the opportunity to read this consent form and have had the opportunity to ask any questions that I may have regarding this consent or the massage treatments that I will receive.

 

Client Name: __________________________________________                                              Date:_______________________________________

 

Client Signature________________________________________