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Meet Sabrina
Virtual Tour
Healing the World
Contact Me
Therapies
Pricing
Massage Therapy
Prenatal & Maternity Massage
Electronic Acupoint / Neurostim
Cupping Therapy
Reflexology
Shinrin-Yoku Therapy
Reiki & Biofield Energy Work
Light Therapy
Sound Therapy
Intake Forms
General Intake Form
Informed Consent Form
Prenatal Release Form
Covid-19 Protocol & Release Form
Article Archive
Events & Workshops
I Aspire
Home
About
Meet Sabrina
Virtual Tour
Healing the World
Contact Me
Therapies
Pricing
Massage Therapy
Prenatal & Maternity Massage
Electronic Acupoint / Neurostim
Cupping Therapy
Reflexology
Shinrin-Yoku Therapy
Reiki & Biofield Energy Work
Light Therapy
Sound Therapy
Intake Forms
General Intake Form
Informed Consent Form
Prenatal Release Form
Covid-19 Protocol & Release Form
Article Archive
Events & Workshops
Intake Forms
General Intake Form
Informed Consent Form
Prenatal Release Form
Covid-19 Protocol & Release Form
Informed Consent Form
Name
*
First Name
Last Name
Policies & Procedures
Please read carefully & initial next to each policy before receiving any services or Therapies.
I understand that the L.M.T. providers of iAspire LLC are State Licensed and may hold other certifications within massage associations as well as other modalities. These licensed professionals of iAspire LLC are allowed to perform all of the services contained within the scope of practice for their respective license/certificates.
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I understand that any massage, body work, and/or energy work I receive is provided for the purpose of relaxation and/or relief of muscular tension, to help me renew my body, mind, and spirit; and is not a substitute for medical examination, diagnosis or treatment. If I expereince any discomfort during the session, I will immediately inform my provider so they can make adjustments or stop the pressure, stroke, technique and/or massage modality being used. I further understand that deep tissue/theraputic massage may cause delayed body soreness and/or bruising; in addition, if cupping is applied it may result in skin discolorations.
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I understand that my providers are teachers/coaches and may provide this service to me while I am either on the massage table or having another service offered. I have the opportunity to come into new awareness, as well as become more aligned with my inner spiritual life. I have sole responsibility for making informed decisions about my own health. nutrition, therapies, intuitive insights, healing, and wellness. I further understand that I might experience some discomfort as emotional issues arise while I am healing myself or making changes in my life; if it becomes too uncomfortable, I further understand that I have the right to end the session at any time should I feel dissatisfied or uncomfortable with the session in any way. I further understand that the providers/staff members of iAspire LLC share these same rights.
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I understand that the providers of iApsire LLC are not qualified to preform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness. I also understand that as my body becomes more relaxed and loose, it is possible for my own body to self-adjust. I understand that any advice given during my services are recommendations to assist me with my health goals and all actions and follow up research/self-education is my choice and responsibility.
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I understand that it is my responsibility to keep my provider(s) informed of any changes in my current health status, any diagnosed medical conditions and medications; failure to do so may place me at greater risk of adverse reactions to massage or other body treatments.
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I understand that if any provider/staff member of iAspire uses any products or equipment that may be contraindicated for any reason, I will be given a list of those contraindications in writing before I agree to accept that product or use of that equipment.
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I understand my identity and any information about me, whether I share it with any provider/staff of iAspire LLC or if any provider of the company discovers it on their own, it will be held in the strictest confidence; except when released by me or specifically required by law. I have the right to waive this confidentiality agreement in whole or part at any time.
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I understand that iApsire LLC has a cancellation, lateness, and no-show policy. I agree to adhere to this policy by giving at least 24hours of notice for a desired cancellation, otherwise I will pay 50% of the missed appointment price.. I understand that if I no-show for an appointment by giving no notice as well as not showing up for a set appointment, I will pay the FULL price for the missed service(s) and that repeated no shows will result in having to prepay for my appointments in the future. I also understand that if I am running late for an appointment, I will notify the staff/provider(s) of iAspire LLC as soon as possible and that I am responsible for managing my time and for missing all or part of my appointment(s). I agree to pay for the full appointment(s) time I scheduled. I understand that iApsire LLC reserves the rights to wave these fees at their digression based on individual circumstance and appointment availability.
I have read all the information provided and understand as well as agree with iAspire LLC's polices, procedures and received a copy. In addition to the informed consent form, I understand that a client intake form must be filled out completely before any services or therapies can be provided. I also understand I will be notified of any disclosures and abide by them.
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Please Sign & Date Below to serve as your Electronic Signature.
E-signature & Today's Date
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Please list the e-mail that you would like a copy of this form sent to for your records:
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Thank you!