The Fountain Spa

Sports Massage Intake Form

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    I understand that facilitated stretch therapy (FST) is provided for stress reduction, relaxation, relief from muscular tension, and improvement of circulation, range of motion and energy flow.If I experience pain or discomfort during the session, I will immediately inform my practitioner so that pressure can be adjusted to my level of comfort. I will not hold my practitioner responsible for any pain or discomfort I experience during or after the session.I affirm that I have notified my practitioner of all known medical conditions and injuries.I agree to inform my practitioner of any changes in my health and medical condition.I understand that stretch therapy sessions are designed to assist in greater stretch gains and are non-sexual in nature.I agree that this is NOT considered Physical TherapyI understand that the services offered today are not a substitute for medical care. I understand that my practitioner is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness.By signing (checking) this release, I hereby waive and release my practitioner from any and all liability, past, present, and future relating to these fascial stretch sessions/bodywork. I have read and agree to these policies therein.Information and Suggestions • Prior to your stretch, please remove jewelry or watches. • Pull long hair back with a clip or band. • Please wear loose, long, comfortable clothing that allow for freedom of movement. • Feel free to ask your practitioner any questions before, during, or after the session.

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