Please complete this waiver and covid safe form before your session.

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

Immersion Type
What  kind of focus would you like your session to have?

Health History

List any known allergies, or aversions to essential oils?

Musculoskeletal
Nervous System
Respiratory
Circulatory
Reproductive
Skin
Digestive
Psychological
Others

Any other medical condition(s) not listed:

Please explain any of the conditions that you have marked above:

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 this practitioner.

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 my practitioner of any changes in my health status. 

terms & conditions
By purchasing this workshop/training with Massoga® Massage Yoga you agree its owners, teachers and any person employed by Massoga® Massage Yoga is in no way responsible for the safekeeping of my personal belongings. I understand that classes may be physically strenuous, I will be adjusted and massaged, and I voluntarily participate in this with full knowledge that there is risk of personal injury, property loss or death. I agree that neither I, my heirs, assigns or legal representatives will sue or make any other claims of any kind whatsoever against Massoga® Massage Yoga or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.

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