Please take the time to carefully complete this form in it’s entirety as it will be used by the clinic as reference for all of your treatments.
…understand that the massage, acupuncture and treatment sessions I receive are provided for the basic purpose of relaxation, ease symptoms and relief of muscular tension.
If I experience any pain or discomfort during this session, I will immediately inform the therapists and/or practitioners, so that the pressure and/or treatments may be adjusted to my level of comfort.
I further understand that my treatments at Exige should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician or other qualified medical specialist for any mental or physical ailment.
I understand that the therapists and 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.
I understand that bruising and tenderness can result from my sessions and may cause my body to detoxify, such symptoms may include, but not limited to body aches, drowsiness, etc…
I also understand the effectiveness of my sessions may cause my motor reaction and alertness to be affected, hence I agree not to leave the premises until I am fully alert and conscious of my actions and understand that there shall be no liability on the therapists’ or practitioners’ part should I fail to do so.
Because massage, acupressure and acupuncture should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly.
I agree to keep the spa updated as to any changes in my medical history, profile information and understand that there shall be no liability on the therapist’s, practitioner’s and spa’s part should I fail to do so.
I give permission for therapists and practitioners to discuss my medical history for the purpose of my treatment sessions.
I acknowledge there is a 24-hour cancellation policy in effect. This policy is in place to reflect our commitment to you and ensures that your spot is never given to someone else. If you need to reschedule or cancel, simply notify us by email, text message or phone call, 24 hours prior to your appointment.
Any cancellation with less than 24 hours’ notice will result in a full charge.