Specializing in Myofascial Release Theraphy &
Clinical Soft Tissue Theraphy
Accepts Workers' Compensation Insurance
DISCLAIMER
By attending any session/treatment, you (the client) understand that the massage/posture therapy/posture exercise/corrective exercise/educational information you receive is provided for the basic purpose of relaxation, relief of muscular tension and educational purpose only. If you experience any pain or discomfort during the ession/treatment. You'll immediately inform the therapist/trainer to adjust the pressure and/or strokes to your level of comfort. You further
understand that massage should not be construed as a substitute for medical examination, diagnosis, or medical medical treatment and that you should see a physician, chiropractor or other qualified medical specialist for any mental
or physical ailment that you're aware of. You understand massage therapists/trainers are not medical professionals. The information that you received is for received is for educational purposes only. It should not substitue traditional medical treatment.
You understand that massage therapists/trainers 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/posture correction should not be performed under certain medical conditions, you affirm that you have stated all my known medical conditions, and answered all questions honestly. You do hereby
acknowledge that you have been informed of the need for a physician’s permission for participation in massage
therapy/posture correction/posture exercise program. You agree to keep the therapist updated as to any changes in
your medical profile and understand that there shall be no liability on the therapists/personal trainers part should you fail to do so. you do hereby waive, release, and forever discharge Cybil Louie, CMT, Pain Relief Treatment Center LLC, families, agents, employees, representative, executor, and all other from the any and all responsibilities or
liability from injuries or damage resulting from your participation in using any equipment, any exercise, massage
therapy and/or posture therapy session. It is your choice to receive massage therapy/posture therapy/posture
exercise, and you give your consent to receive treatment. You do understand that you can dismiss the service at any
time during the session. You have read and agreed to all the items said above as well as the terms of this instrument
and understand that by booking online you will ask to fill out and sign a intake form before your first visit.
CLICK HERE for intake form.