Information AgreementInformation Agreement • June 26th, 2023
Contract Type FiledJune 26th, 2023CONTACT INFORMATIONTo Be Completed By Client Name Mobile Phone Number OK to leavemessage I would like to receive Text Notifications (Messaging & Data Rates may apply; Please list service provider): Address City/State Zip Email Address Date of Birth Emergency Contact Name & Phone Number ELEMENTS MASSAGE® POLICIESPlease review and check each box. (Please ask us if you have any questions, concerns or need additional information): I may undress to my comfort level. I will be properly draped, meaning covered by the sheet and/or blanket at all times. The therapist will only uncover the part of the body that is being worked on during the massage session.As further explained below, the therapist reserves the right to terminate the session at any time in the event of any sort of inappropriate behavior from me. Elements Massage® therapists do not perform breast massage.If I am under the age of 18, my parent or guardian must sign a Minor Consent Form and must be present in the room during the
Information AgreementInformation Agreement • September 15th, 2022
Contract Type FiledSeptember 15th, 2022CONTACT INFORMATIONTo Be Completed By Client Name Mobile Phone Number OK to leavemessage I would like to receive Text Notifications (Messaging & Data Rates may apply; Please list service provider): Address City/State Zip Email Address Date of Birth Emergency Contact Name & Phone Number ELEMENTS MASSAGE® POLICIESPlease review and check each box. (Please ask us if you have any questions, concerns or need additional information): I may undress to my comfort level. I will be properly draped, meaning covered by the sheet and/or blanket at all times. The therapist will only uncover the part of the body that is being worked on during the massage session.As further explained below, the therapist reserves the right to terminate the session at any time in the event of any sort of inappropriate behavior from me. Elements Massage® therapists do not perform breast massage.If I am under the age of 18, my parent or guardian must sign a Minor Consent Form and must be present in the room during the