Consultation forms Please enable JavaScript in your browser to complete this form.Name *DateAddressPhoneEmergency contactHow did you learn about us?Do you have any recent surgery? YesNoAre you on any medication? YesNo Address us? Are **Please mark any of the following conditions you may currently have.Neck injuryInfectionpmsEmotional changesSinus congestionHeadachesCold virusFluAllergiesAlcohol within 24hrsKidney alignmentSports injuryPhlebitisBruisesHigh Blood pressureVaricose veinsAcute painGrief processRecent surgeryOpen woundsOsteoporosisChronic painsBlood clotFever within 24hrsWear contactsOthers, please specifyConfirme PleaseI understand that massage therapy is for the purpose of stress reduction, relief from muscular tension or spasm, or for increasing circulation. I understand that the massage therapist does not diagnose illness, disease or any other physical or mental disorder. The massage therapist does not prescribe medical treatment nor perfom spinal manipulations. I will inform the therapist of my current condition at the time of each visit.Paragraph TextThank you for using our services By signing below, you agree to the following: I give my permission to recaive massage therapy. SiaeaI understand that Therapeutic massage is not a substitute for traditional Medicinal treatment or medications. 3. 1 understand that the massage therapist does not diagnose illnesses or injuries, or prescribe medications. 4. 5. I have clearance from my physician to receive massage therapy. 1 understand the risks associated with massage therapy include, but are not limited to: 1. 2. 3. Superficial bruising Short-term muscle soreness Exacerbation of undiscovered injury I therefore release the company and the individual massage therapist from all lability concerning these injuries that may occur during the massage session. I understand the importance of informing my massage therapist of all medical conditions and medications I am taking, and let the massage therapist know about if changes to these. I understand that there may be additional risks based on my physical condition. 4. I understand that it is my responsibility to inform my massage therapist of any 5. discomfort I may feel during the massage session so he/she may adjust according 6. I understand that Tor the massage therapist may terminate the session at any time 7. I have been given a chance to ask questions about the massage therapy session and my questions have been answered. I consideration of being allowed to participate in spa services provided by Mellisauna’s Oasis Spa, Cayman, I hereby release, waive, and discharge Mellisauna’sOasis Mobile spa Cayman, and, its owners, employees, agents, and contractors from any and all liabilities, claims, demands, or causes of action that may arise from my participation in the treatments, including but not limited to personal injury, property damage, or wrongful death. Signature *Submit