Therapeutic services are a non-sexual health-care. At no time during the massage will the therapist massage genitalia, and I understand that this massage is given in a strictly non-sexual manner. Unless otherwise stated in treatment notes or by you, you will receive a full body massage. In all massage modalities and sessions, draping will be used. Massage is a service intended for enhancing your health and quality of life. If at any time you are uncomfortable with the massage, please inform the therapist and he/she will gladly rectify the problem, including ending the session if you upon your request..

Note: If you are taking medication for high blood pressure or diabetes Authentic Thai Massage is not available.

If Pain Is a Factor, Please Complete the Following!

I release Soifah Thai Massage from any responsibility for pre-existing conditions I have not revealed or any consequential changes to those conditions that arise subsequent to the treatment.

I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically.

Signature of Legal Guardian if under the age of 17