I will immediately inform the practitioner if there is something I am uncomfortable with or if I would like them to stop treatment on my child at any point during the session. I further understand that massage/bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and that my child should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware. I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such. Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my child’s medical profile and understand that there shall be no liability on the practitioner’s part should I fail to do so. Understanding all of this, I give consent for my child to receive care.
I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this form.
