Liability and Consent Form:

NeuroMuscular Pain and Wellness Center

The treatments and therapeutic services provided by our licensed therapists at NeuroMuscular Pain & Wellness Center are intended to help reduce pain and muscle tension, improve mobility, increase circulation, decrease muscle tension, promote relaxation, support nervous system regulation and support overall wellness. These services are complementary in nature and are not a substitute for medical diagnosis, treatment, or prescribed medications.

The benefits, possible side effects, and any applicable contraindications of these therapies have been explained to me. I understand that temporary soreness, tenderness, bruising, redness, fatigue, lightheadedness, or a temporary increase in symptoms may occur following treatment.

I understand that my massage therapist does not diagnose illness or disease, prescribe medications, or perform spinal manipulations. I certify that I have accurately disclosed all known medical conditions, injuries, surgeries, medications, allergies, pregnancy status, and other relevant health information. I agree to notify my therapist of any changes to my health before each treatment.

If I am pregnant, suspect I may be pregnant, am postpartum, have recently undergone surgery, or have another medical condition for which my therapist determines medical clearance is necessary, I understand that NeuroMuscular Pain & Wellness Center requires written medical clearance from my physician or other qualified healthcare provider before treatment may be provided.

I understand that I am responsible for communicating with my therapist throughout my session. If I experience pain, discomfort, numbness, dizziness, or any unexpected symptoms, I will immediately notify my therapist so treatment can be modified or discontinued. I understand that I may request modification or discontinue treatment at any time.

I understand that no guarantees have been made regarding the results of any treatment. I voluntarily consent to receive therapeutic bodywork services from NeuroMuscular Pain & Wellness Center and agree to abide by all office policies.

To the fullest extent permitted by applicable Arizona law, I release NeuroMuscular Pain & Wellness Center LLC, its owners, employees, independent contractors, and agents from liability for claims arising from the ordinary, inherent risks associated with properly performed therapeutic bodywork services, except where liability cannot legally be waived.

I acknowledge that I have read, understand, and voluntarily agree to this Liability and Consent Form.

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