Thank you for your interest in Fascia Stretch Therapyā„¢.
Please scroll to the bottom and agree to theseĀ terms prior to your session.
Fascia Stretch Therapy Waiver
I agree to inform the therapist of any medical conditions. I understand that bodywork I receive is for the purpose of increased flexibility, stress reduction and relief from muscular tension, spasm or pain, and to increase circulation. If I experience any pain or discomfort, I will immediately inform my therapist so that the intensity and/or methods can be adjusted to my comfort level. I understand that utilization of this type of modality can possibly increase soreness and/or pain if I do not communicate honestly. I understand that information exchanged during any session is educational in nature and is intended to help the client become more familiar and conscious of his or her own health status.Ā
I understand that an FST Practitioner cannot diagnose illness, disease, or any physical or mental disorders. As such, the therapist does not prescribe medical treatment or pharmaceuticals. It has been made very clear to me that this therapy is not a substitute for medical examinations and/or diagnosis, and I understand that it is my responsibility to consult a physician for any ailments I may have.Ā
Given the above, I understand that response to treatment varies on an individual basis and that specific results are not guaranteed. I understand that I am choosing Fascial Stretch Therapyā„¢ at my own risk. In the event that I experience any injury, whether directly or indirectly related to the therapy provided, I agree to release and hold harmless [Shannon Hershman/Be Well My Body, LLC] from any and all liability for any condition or outcomeā€”known or unknownā€”that may result from the treatment I receive.Ā
Sexual advances and other verbal or physical conduct of a sexual nature will constitute as sexual harassment and will not be tolerated, resulting in the immediate termination of the session and I will be liable for payment of the scheduled treatment.
I agree to abide by a 24 hours cancellation notice for any scheduled appointment. I understand I may be charged up to the full amount of the service for missed appointments or for any cancellations with less than a 24-hour notice. I understand that if I arrive late for an appointment, the session will end at the original scheduled time to prevent penalizing another client. However, if the therapist is late, they will fulfill the scheduled appointment length or offer a reasonable compensation.
