I, hereby consent to receive the indicated services provided by Blind Sight Physiotherapy. I understand that these services involve physical contact and manual manipulation of the body, and I voluntarily agree to undergo such treatment.
Acknowledgement of Risks:
I acknowledge that:
1. Musculoskeletal Physiotherapy: This involves the assessment and treatment of musculoskeletal conditions which may cause discomfort.
2. Sports Massage: This involves deep tissue manipulation which may cause discomfort or bruising.
3. Relaxing Massage: This is generally gentle but may still involve physical contact that could cause minor soreness.
4. Hot and Cold Stone Massage: This involves the application of hot and cold stones which may cause temporary redness, swelling, or other minor reactions.
5. Personal Training: Physical exercise programmes can lead to muscle strain, soreness, or injury.
6. Ayurvedic Consultation: This involves personalised assessments and recommendations based on Ayurvedic principles, which may include pulse and tongue assessments, dietary, lifestyle, and herbal suggestions.
7. Ayurvedic Therapies: This includes traditional Ayurvedic treatments which may involve the use of herbal oils, powders, and other natural substances, and may cause temporary discomfort, redness, or allergic reactions.
I understand that while the therapists will take all necessary precautions to ensure my safety and comfort, there are inherent risks associated with these treatments.
Confidentiality:
I understand that all information shared during my sessions will be kept confidential and will only be disclosed with my written consent or as required by law.
Cancellation Policy:
I acknowledge that I have read and understood the cancellation policy. Cancellations or changes to appointments must be made at least 24 hours in advance to avoid a cancellation fee.
Payment and Fees:
I agree to the fees associated with the services provided and understand that payment is due at the time of service unless other arrangements have been made.
Consent to Photograph:
(Optional) I consent to the use of photographs for educational or promotional purposes.
Signature:
By signing below, I confirm that I have read and understood this consent form. I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.
