The Well Pasadena Chair Massage Waiver

First name

Last name

Phone

I understand and certify that I am at least 18 years of age and legally able to receive massage and other bodywork services/treatment.

I have my doctor’s permission to participate in bodywork/ massage activities.

Please specify any medical conditions, injuries or other health-related information we should know about.

I affirm that I have notified my therapist of all known medical conditions and injuries.

If I experience pain or discomfort during the session, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort.

I will not hold my therapist responsible for any pain or discomfort I experience during or after the session.

Signature Authorization and Consent

簽名欄位為空白。

By signing this form, I agree to the terms and conditions of The Well Pasadena and release my therapist from liability related to massage therapy and bodywork, past, present, and future.

I grant permission for The Well Pasadena to photograph or record me for use in marketing and educational materials, without compensation. I waive any right to review or approve such materials.

I also consent to receive communications about services and understand I may opt out anytime.