By completing and signing this form, I confirm that I am at least 18 years old or, if I am a minor, have provided a separate consent form signed by my parent or legal guardian.
I am voluntarily seeking assisted stretch therapy at The Stretch Spot and understand the nature and purpose of these services.
Client Records and Health Information
The Stretch Spot maintains confidential client records in accordance with applicable privacy requirements, including HIPAA where applicable. Session records include:
Appointment date and time.
Services and techniques provided.
Observations and session outcomes.
Recommendations for future sessions and at-home wellness care.
These records help support safe, effective services and identify conditions that may make stretching inappropriate based on my disclosed medical history or changes in my health.
I agree to complete an updated liability waiver and health intake form every 1–2 years, or sooner if my health changes in a way that could affect my ability to receive stretch therapy. A copy of my signed form will be sent to the email address I provide.
Informed Consent for Assisted Stretch Therapy
I understand that assisted stretch therapy is a form of manual bodywork in which a trained therapist gently guides my body through range-of-motion exercises. Based on my initial assessment and consultation, sessions may involve lying face down, face up, or on my side.
Assisted stretch therapy is intended to improve flexibility, reduce muscle tension, and support overall wellness. It is not a substitute for medical care and is not intended to diagnose or treat medical conditions. I voluntarily choose to participate in these wellness services.
I understand and agree that:
Sessions are guided by the therapist’s training, assessment, and recommendations.
Sessions may be adjusted to address new symptoms or areas of concern.
Focusing on only one area of the body may limit the overall benefits of a session.
I must promptly communicate any pain, discomfort, or need to adjust pressure or positioning.
I confirm that I have disclosed all known medical conditions and injuries. I release The Stretch Spot and its staff from liability arising from conditions I did not disclose before my session. If I have concerns about my health or ability to participate, I have consulted a physician or will do so before receiving services.
Video Recording Consent
The Stretch Spot uses video cameras within the facility to support client and staff safety, security, and training. By signing this form, I acknowledge that I may be recorded while receiving services and consent to video recording for:
Recordings will be viewed only by authorized personnel. They will not be shared publicly or used for other purposes without my additional consent, except as required by law.
Conduct Agreement
I agree to maintain respectful and professional behavior during all sessions. I understand that sexually explicit, suggestive, violent, offensive, or otherwise inappropriate verbal or physical behavior will result in immediate termination of the session. No refund will be provided for a session ended because of misconduct.
Acknowledgment and Signature
I confirm that I have read and understand this form. I consent to receive assisted stretch therapy from a certified and insured professional at The Stretch Spot.
I release The Stretch Spot and its therapist from liability for adverse effects not caused by negligence or misconduct.
