I understand this massage is being giving by a student. I understand that massage therapy is given for the purpose of stress reduction, relief from muscular tension or spasm, and for increasing circulation and energy flow. Massage services are designed to be a health aid and are in no way to take the pace of doctor's care. Information exchanged during any massage session is educational in nature and intended to help me become more familiar and conscious of my own health status and is to be used at my own discretion.
I understand that the massage therapist does not diagnose illness, disease or any other physical or mental disorder. As such, the massage therapist does not prescribe medical treatment or pharmaceuticals, nor does he/she perform any spinal manipulations. It has been made very clear to me, that massage therapy is not a substitute for medical diagnosis and treatment and I should see a physician for any ailments I might have.
Because massage is contraindicated (should not be performed) under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the therapist updated as to any changes in my medical profile and understand there shall be no liability on the therapist's part should I forget to do so.

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