Client Intake Form

Intake Form Disclaimer/Release

Mystic Mobile Massage

Mystical Relaxation at your convenience.

By submitting the Client Intake form I understand that therapeutic massage/bodywork is a health aid and does not take the place of a doctor's care. If I experience pain or discomfort during the session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. Because massage/bodywork should not be performed under certain medical conditions, I affirm that I shall state all my known medical conditions and answer all questions honestly. I agree that my practitioner, Mystic Mobile Massage, and its staff shall not be liable should any injury occur, due to my withholding information, or for any other reason. I agree to keep my current and future practitioners updated as to any changes in my medical profile, and I understand that there shall be no liability on the practitioners' part should I fail to do so. Information exchanged during any therapeutic session is educational in nature and is intended to help me become more familiar and conscious of my own health. It is to be used at my own discretion and is not to be construed as medical advice. I acknowledge that this a professional environment and the practitioner has the right to terminate the session at any time for any inappropriate behavior and payment will be due for the full session.