It is my choice to receive massage therapy. I am aware of the benefits and risks of massage and give my consent for massage. I understand that there is no implied or stated guarantee of success of effectiveness of individual techniques or series of appointments. I acknowledge that massage therapy is not a substitute for medical care, medical examination or diagnosis. I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status. 

I understand that my personal health information will be collected. I understand that all information that I provide will be kept confidential unless required by law. I understand and consent that my medical information may be shared by the various care  providers involved in my care and treatment. Treatments may be covered by extended health care plans. I understand that it is my responsibility to confirm the exact details of my coverage.

If seeking any alternative treatment such as Reiki, Hypnotherapy, Sound baths, etc.  I understand that my practitioner is not a medical doctor (physician, psychiatrist, psychologist, etc.) and makes no claim to diagnose or offer treatment of disease. I understand that alternative treatments are not a replacement for medical treatment, psychological/psychiatric services, or counseling. I also understand that our practitioners do not treat or diagnose any condition and that she is a facilitator of hypnosis, Reiki, or other alternative treatments. I understand that our practitioners have the best interest in mind and will offer guidance where asked, they are not responsible for my own well-being and decision making. I also understand that I am responsible for my own interpretations of and reactions to the information presented to me. I understand that the experience of hypnosis, Reiki, or any other alternative treatment is meant to present information that may contribute to mind, body, and spiritual balance and that Infinity Massage and Bodywork, LLC are not responsible or liable for the information I receive during the session. I also understand thatd Infinity Massage and Bodywork, LLC is not responsible for my interpretations of the information or the decisions I make based on the information. I understand that I am responsible for my own judgment and that all participation, interpretations, and decisions are my own. I understand there are some conditions for which hypnosis may not be a good fit for the client. These conditions include (and are not limited to): Schizophrenia, pathological personalities, psychosis (including substance induced), senility, dementia, brain trauma, cognitive deficiencies, epilepsy, narcolepsy, bi-polar, clinical depression, suicidal tendencies, serious heart conditions, extremely high/low blood pressure, elderly/frail, substance abuse, and/or currently taking medications/substances that cause drowsiness. I understand that if I am, in any way, unsure if hypnosis, Reiki, or any other alternative treatment would be a good fit for me, that it is best to consult my medical doctor prior to participating in hypnosis, Reiki, or another alternative treatment. Also, if pregnant (especially in the first or second trimester), I will also consult my medical doctor prior to participating in hypnosis, Reiki, or another alternative treatment. I understand that by signing this document, I am accepting full responsibility for monitoring my health for this and any future group and/or individual hypnosis, Reiki, or other alternative treatment sessions. Should the aforementioned conditions present themselves in the future, I understand and agree that I shall not participate in future sessions without first consulting with and receiving expressed consent from my health care provider.  I hold Infinity Massage and Bodywork, LLC and its agents harmless for any outcome of my participation in the treatment.

***IT IS MY RESPONSIBILITY TO IMMEDIATELY INFORM MY PRACTITIONER IF ANY LEVEL OF DISCOMFORT IS FELT DURING ANY TREATMENT.***

 I have read and understand the above Release of Liability agreement. By my signature I consent to this agreement.