The massage waiver on the iPad brings you a perfect experience.

Life Massage

Waiver & Informed Consent

Please fill your name: *

Please enter your full name.

Date of Birth: *

Please enter valid date.

Please fill in Address: *

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Phone number: *Please enter your phone number.

Email: *Please enter your email.

Have you received massage therapy recently? *Please enter your answer here.

What type of pressure do you prefer? *Please enter your answer here.

Are there specific areas you would like your therapist to focus on? *Please enter your answer here.

Areas to stay away from? *Please enter your answer here.

Have you recently sustained an injury or chronic pain?? *Please enter your answer here.

Are you taking any medications? *Please enter your answer here.

Please take the time to inform us if there are any medical conditions we need to be aware of... *Please enter your answer here.

Do you currently use cannabis? *Please enter your answer here.

Do you have any allergies? *Please enter your answer here.

Are you currently pregnant or breastfeeding? *Please enter your answer here.

How did you come to be aquainted with us? *Please enter your answer here.

I the undersigned have provided all pertinent and up to date medical information. I understand that massage therapy is not a substitute for medical diagnosis or treatment. I understand that my massage therapist has an extensive and comprehensive understanding of Cannabis and how it can be used in massage therapy. I understand that my massage therapist may not prescribe or dispense cannabis. If I choose to engage in a CBD massage, I agree to the use of a non regulated canna salve to be applied to my skin during the massage. I will not hold the owners/operators of 1626 R 34 ave SW responsible for any damages that could be construed during this process. I do not hold Life Massage and it's practitioners responsible for any damages that may arise once I leave the premises. I understand that if I, or my massage therapist, feels uncomfortable at any time the service can be terminated and a possible fee MAY be charged to compensate for my therapists time.

I acknowledge that CBD massage is still widely experiential in nature and that by signing this document I agree to the terms above.

We may ask to share your story through our social media, is this something that would interest you? *Please enter your answer here.

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