Client Confidentiality Form

The reactions vary for each person and for each Reflexology and Remedial Massage Session. You may react with feelings of relaxation, peace, calm or even by falling asleep. However, you may experience the different reaction of pain release, energy release, stress release, emotional release or even a few tear. This may be described as a "Healing Process of Your Body." These reactions may continue for a few days as your body works towards a state of Body Balance. If your reactions continue beyond a few days please call your practitioner for assistance. Please write your name in the below box to indicate consent.

This is not a medical treatment or diagnosis of injury or illness. I confirm that if I require medical treatment or diagnosis then I will seek the services of a medically qualified doctor for this purpose. I understand the goal of Reflexology and Remedial Massage is to assist the body to achieve a state of Homeostasis or Body Balance. I understand this Reflexology and Remedial Massage Session will be tailored towards my expected outcomes as agreed with the Practitioner. The effects of the treatment have been fully explained to me and I consent to this Reflexology and Remedial Session. I consent to have my feed photographed for records and training purposes. Please print your name in the form below to indicate consent