StressAllergiesContagious diseaseDiabetesWear contact lensesBack painDepressionCancerCardiac/circulatory problemsArthritisFrequent headachesSensitive to touch or pressureOsteoporosisEpilepsy or seizuresBruise easilyJoint swellingVaricose veins
I understand that the treatment I receive is provided for the basic purpose and relief of an injury. If I experience any discomfort during the session, I will immediately inform the therapist of my discomfort. I further understand that treatment should not be construed as a substitute for medical examination. I understand that the therapist is not qualified to diagnose, prescribe, or treat any mental illness, and that nothing said in the course of the session given should be construted as such, because the treatment should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree to keep the therapist updated as to any changes in my medical profile during today’s and all future sessions, and understand that there shall be no liability on the therapist's part should I fail to do so. I am aware that the therapist is a sole trader. I also understand that the license therapist reserves the right to refuse to perform treatment on anyone whom he/she deems to have a condition for which the treatments they use are contraindicated.