Please complete this covid safe form before your retreat.

Please note; do not use auto fill when completing this waiver or the form will not submit. Thank you.

Please answer each section, and tick the client agreement before submitting the form. Thank you.

Have you had a fever in the last 24 hours of 38°C or above?
Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?
Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?
Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?

covid consent

I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive massage and bodywork from the Massoga® practitioners.

client agreement

It is my choice to receive massage therapy. I am aware of the benefits and risks of massage and give my consent for massage. I understand that there is no implied or stated guarantee of success of effectiveness of individual techniques or series of appointments. I acknowledge that massage therapy is not a substitute for medical care, medical examination or diagnosis. I have stated all medical conditions that I am aware of and will inform the Massoga® practitioners of any changes in my health status. 

© 2020 Massoga® Massage Yoga | Website by Insight Culture