Couples' Massage Workshop Participant Agreement and Conduct Waiver

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I understand that the Couples’ Massage Workshop is intended to be a fun and interactive learning experience that will help improve communication between my partner and I, in addition to preparing us to give and receive the most effective and comfortable massages at home.

I understand the importance of being respectful in the workshop environment, as it can involve both intimate and vulnerable moments between partners.

I also understand that any comments, gestures, behaviors or attire that is/are deemed inappropriate are grounds for ending the workshop early for respective couples.

I understand that any disrespect aimed at the instructor, a partner, or other participant will not be tolerated and is cause for early dismissal from the workshop.

I understand that the massage techniques taught in this class are for home-use and recreational purposes only and should not take the place of medical treatment.

I understand and agree that videos and pictures taken at the workshops may be used for marketing and advertising purposes on my website and social media.

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Cupping Therapy - Consent and Release Form

ABOUT CUPPING THERAPY

Cupping is a therapeutic technique that comes from traditional Chinese medicine (TCM) and is believed to have numerous health benefits in addition to stimulating the flow of qi ("life force") within the body. This body treatment integrates well with massage therapy, and involves applying a localized negative pressure (suction) to the skin using glass, plastic or silicone cups at targeted areas of the body. The intent of this therapy is to stimulate the function of the circulatory and lymphatic systems. It may also help to release congested tissues and loosen adhesions at superficial tissues of the body.

Contraindications for Cupping Therapy

The following is a partial list of common conditions which are considered contraindications for cupping therapy:

Blood clots, Bleeding disorders, Bruise easily, Hemophilia, Skin lesions, Cancer, Areas of herniation, Hematomas, Phlebitis / varicose veins, Impaired sensation, Edema / lymphedema, Certain medications, Injured areas, Infections Acute skin conditions, Sunburn / rash

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Information about massage cupping in general, techniques, potential benefits, effects, risks, after-care recommendations, and possible alternative therapies have been explained to me and I understand this information.

I understand that the vacuum formed by cupping may result in marks being left on my body.

My therapist has informed me of the contraindications of cupping therapy, and I have provided my therapist with an accurate and complete medical history to rule out any contraindications to receiving this treatment.

I agree to communicate to my therapist any physical discomfort experienced during the session.

I am not taking blood thinners, and I have no contraindications for cupping therapy.

I release the massage therapist and business from all liability for any harm that may unintentionally result from this treatment.

I further understand that massage and cupping therapy is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware. I understand that massage therapists do not diagnose illness or disease, and nothing said during the treatment should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken.

By signing this form I agree with the statements above and give my consent to proceed with cupping therapy.

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Massage Therapy Minor Consent Form

*Clients under the age of 18 must have this form completed by their parent or guardian.

-Massage service offered at this practice is for the purpose of general wellness, stress reduction, and relief of muscular tension.

-I (parent or guardian) must remain at this massage office for the duration of the minor's massage session. I may remain in the treatment room throughout the treatment. I (parent or guardian), the client, or the massage therapist may terminate the session at any time.

-The client does not have any injuries or conditions that prevent receiving massage therapy. I understand the importance of informing the massage therapist of all medical conditions and medications that the client is taking, and that there may be additional risks based on the client's physical or mental conditions.

-The client must immediately inform the therapist of any pain or discomfort so that the pressure or techniques used can be adjusted to remain within comfort limits. The massage therapist is not responsible for any pain or discomfort experienced during or after the treatment.

-I have been given the opportunity to ask questions about massage therapy and my questions have been answered. Also, I have been advised of the policies and procedures pertaining to massage and I understand these policies.

Information regarding massage in general, benefits, risks, contraindications of massage, and possible alternative therapies have been explained to me. I further understand that massage therapy is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware. I understand that massage therapists do not diagnose illness or disease, and nothing said during the massage should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken.

Name of Client/Minor (Print)

Parent/Guardian Name (Print)

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AromaAlign Essential Oil Treatment Release Form

AromaAlign Aromatherapy treatment is a complementary therapy that uses essential oils from plants and flowers. Aromatherapy and essential oils can have a positive effect on the body. They aim to improve well-being and reduce stress.Aromatherapy is designed to affect the whole body, rather than targeting the symptom or disease. It assists the body’s natural abilities, helping to maintain balance, repair and recover.

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Do you have skin sensitivities? If so, please list any issues you experience.

Do you have allergies or sensitivities to oils, lotions, scents, foods, medicine, plants, etc?

Are you currently pregnant or breastfeeding?

Do you have asthma?

Yes

Have you used therapeutic essential oils before?

Yes

What type (brand/scent) have you used before?

I acknowledge and confirm that:

I understand Aromatherapy is not regulated by the Food & Drug Administration.
I understand that no guarantees are made regarding the results from Aromatherapy
I am not being advised to take any essential oil products internally
I must keep all essential oil products out of the reach of children
Essential oils could be poisonous if swallowed
Essential oils may irritate the skin if not stored or used properly
Essential Oils must not be used with animals
Essential Oils must not be used on the skin of babies or children under 1 year old
Essential Oils must be used with extreme caution for children under 5 years old.

I understand that essential oils and aromatherapy is a complementary holistic therapy and not intended to treat, diagnose, and/or cure any medical issues. I affirm that I have answered all questions accurately and honestly. And realize the importance of notifying the practitioner of any changes that may affect my health profile and understand that there shall be no liability on the practitioner’s part should I forget to do so. I know that I need to seek medical attention by a proper qualified health professional when appropriate. I understand that all my information is strictly confidential and maintained at all times.

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Red Light Therapy Waiver

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Always wear protective eyewear. Failure to wear protective eyewear may result in burns or long-term injury to the eyes.

You should prepare your skin for your session prior to your arrival. For optimal results, the skin should be free of deodorant, makeup, fragrances, oils, and lotions. Remove jewelry.Certain Medications or cosmetics may increase your sensitivity to Red Light Therapy.For optimal results recommended red light therapy schedules are 1-3 days per week, for 4-12 weeks.After treatments sit up slowly to prevent dizziness.I am over 18 years of age.I understand that Red Light Therapy should not be administered to people with the following conditions, and I do not have any of these conditions.a.Persons diagnosed with basil cell carcinomab.Pregnancyc.Epilepsyd.Thyroid Conditione.Taking medications that cause sensitivity to light (example: tetracycline)f.Broken or inflamed areas of the skin.

I understand that Red Light Therapy is not intended to take the place of medical care or medications. To my knowledge, I have no medical condition which would prohibit me from using Red Light Therapy. I acknowledge that the results of Red Light Therapy do vary and that no guarantees of specific results are offered or implied. I have been given adequate instructions for the proper use of the equipment, understand the risks involved, and use it at my own risk. I hereby agree to release the owners, operators, and manufacturers from any damages that I might incur due to the use of this facility.

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