Perfect Paradise
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First and Last Name *
Release Of Liability for Massage Services
Terms and conditions & Release of liability
Please read the terms and conditions and confirm below.   *
I understand that the massage/bodywork I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage/bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and that I 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 my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner’s part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment.
Required
Do you suffer from chronic or persistent pain/discomfort? *
If so, how long?
Are you currently under medical care? *
Are you currently taking any prescription medication? *
Is so, what medication or for what?
Please indicate any condition that you have had or currently have (circle any that apply):   *
Required
Explain any condition you have marked above:  
Are you sensitive to fragrances or perfumes? *
Do you have sensitive skin? *
Massage Information
Have you had a professional massage before? *
If yes, when was your last massage? *
What type of massage are you seeking today? *
 (If your selection differs from what you originally signed up for, the price may be different. If you are unsure, please talk with a staff member.)  
Required
Do you have a pressure preference?   *
Required
Occupation: *
Do you exercise regularly? *
What are your common areas of pain or tension?   *
Massage Therapy Add ons
Optional
Luxurious Add-ons *
Required
CBD oil options-
Choose from an array of Simply Earth Aroma Therapies to add to any session, for just $5.00: *
Required
Today's date *
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If there are any further comments you'd like to make about your appointment, feel free to do so below below:
Submission:
By submitting this form using the button below, I am electronically signing this Release of Liability Waiver on the date entered above and hereby release the spa service provider, Paradise Found Massage & Day Spa LLC, its owners and assigns, from any and all liability or responsibility in case of accident, illness, or injury. I confirm that all information given in this form is true, complete, and accurate. I acknowledge that no assurance was offered about the outcome.
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