This Release of Liability Waiver and Informed Consent Agreement ("Agreement") is made and entered into as of [Date] by and between:
WHEREAS, Therapist provides massage therapy services (the "Services"); and
WHEREAS, Client desires to receive the Services from Therapist.
NOW, THEREFORE, in consideration of the foregoing premises and the mutual covenants contained herein, the parties agree as follows:
1. Informed Consent. Client acknowledges that they have been informed of the nature and purpose of massage therapy, including its potential benefits and risks. Some potential benefits of massage therapy may include relaxation, stress reduction, improved circulation, and pain relief. Some potential risks associated with massage therapy may include discomfort, soreness, bruising, and allergic reactions to massage oils or lotions. Therapist will discuss any specific concerns Client may have before beginning the massage session.
2. Medical Conditions. Client represents and warrants that they have disclosed all relevant medical conditions and medications they are currently taking to Therapist. Client acknowledges that massage therapy may not be appropriate for certain medical conditions and agrees to inform Therapist of any changes in their health status prior to future appointments.
3. Allergies. Client discloses any allergies to massage oils, lotions, or other products used during massage therapy. Therapist will make reasonable efforts to accommodate Client's allergies, but cannot guarantee a completely allergen-free environment.
4. Communication. Client agrees to communicate openly with Therapist throughout the massage session regarding their comfort level and any areas they wish to avoid. Client has the right to request modifications or discontinue the massage at any time.
5. Release of Liability. Client hereby releases, discharges, and waives any and all claims, demands, losses, damages, rights of action or causes of action of any kind, known or unknown, arising out of or in any way connected with Client's receipt of the Services, including but not limited to:
6. Waiver of Claims. Client waives any and all rights and benefits conferred by any statute or regulation that would otherwise limit the effect of this Agreement, to the fullest extent permitted by law.
7. Confidentiality. Therapist agrees to maintain the confidentiality of all Client information, except as required by law or to provide Services.
8. Professional Standards. Therapist agrees to perform the Services in a professional and ethical manner, in accordance with all applicable state and local laws and regulations.
9. Binding Effect. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective heirs, successors, and assigns.
10. Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous communications, representations, or agreements, whether oral or written.
11. Severability. If any provision of this Agreement is held to be invalid or unenforceable, such provision shall be struck and the remaining provisions shall remain in full force and effect.
12. Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of [State], without regard to its conflict of laws principles.
13. Signature Requirements
Print Name:
Date:
License Number:
Disclaimer: This template is for informational purposes only and should not be considered a substitute for legal advice. It's highly recommended to consult with a lawyer to ensure your massage therapy release of liability waiver and informed consent agreement meets all legal requirements in your jurisdiction and effectively protects your business.
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