I am hereby requesting Massage treatments from contracted massage therapists at Therapeutic and Relaxation Massage Clinic which include relaxation, deep tissue, prenatal, essential oil, hot stone and cupping massage. New complications and concerns, if they do arise, will be discussed with my practitioner, and appropriate action will be taken. I understand that although these are natural and alternative treatments, I am seeking, there may be risks of bruising, pain in treated area, and worsening of symptoms during the healing process. I hereby release Therapeutic and Relaxation Massage Clinic and all practitioners/therapists treating me from all liabilities.

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I am also aware of the clinic's late cancellation policy of a charge of 50% of the visit cost if I fail to give less than 24 hours notice for cancellation, I will be responsible to pay that charge before I can re-book.