Informed Consent to Massage Therapy

Informed Consent to Massage Therapy

At Active Life Wellness we thrive to provide best service and care to our clients. Please let us know where you feel we can improve or upgrade to make our service and care better for you. Massage Therapy at our clinic is provided by Registered Massage Therapists who are members of the College of Massage Therapists of Ontario (CMTO) and will do their best to see that you receive treatment best suited to your condition.
We make every effort to be on time for you and we request you to extend same courtesy. If you cannot keep your appointment please notify us immediately. Missed appointments and late cancellations (less than 24 hours in advance except in emergencies) are subject to full cost of the treatment. If you arrive late for your appointment, you will receive treatment for the length of time remaining in your scheduled appointment.
All clients are required to complete a Patient Case History Form. The information requested will assist the Massage Therapist in treating you safely and effectively. Feel free to ask any questions about the information being requested. Please be advised that all information being provided will be kept confidential unless allowed, or required, by law. Your written permission will be required to release any personal information.
The initial visit may include, but is not limited to, the following: completion of Case History form and any necessary paperwork, blood pressure reading and assessments including special orthopedic tests and remedial exercises. The time allotted for your appointment includes time for interview, assessment.
Certain parts of our body that are deemed as sensitive by nature which include chest musculature, breast, buttocks and upper inner thigh. Massage Therapist will need written consent from you before assessing or treating these body parts.
If Massage Therapist find any precautions, contraindication to your massage treatment or anything outside his scope of practice you will be referred to appropriate health care provider. you have right to stop or modify treatment at any time. Please let us know if you need any type of assistance before, during or after the treatment.
I understand and is informed that as in all health care, in the practice of Massage Therapy there are some risks and side effects are involved including but not limited to dizziness, muscle soreness, bruising and fainting. Therapist will advise if there are any particular side effects that relates to specific treatment of my condition.
I have stated all my known medical conditions and have taken it upon myself to keep the Massage Therapist updated on my physical health, allergies specifically related to any lotion, oil, heat or cold for hydrotherapy used in massage.
My signature below indicates full understanding and agreement to the above release and stated conditions of receiving treatment at Active Wellness Clinic.
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On your first appointment with Brampton Chiropractor Dr. Sodhi, you'll sit down to discuss what's brought you in to our office. Dr. Sodhi will complete a full health history and assessment with you. Then, if needed, we'll send you for X-rays. Please contact us today for your appointment.