Latitude Movement
Stretch Therapy & Myofascial Release
Terms & Conditions
Liability Waiver and Informed Consent Form
Acknowledgment of Services Provided
I, the undersigned, understand that the services offered by Latitude Movement include stretch therapy, myofascial release, cupping, kinesiology taping, Graston Technique, and Theragun therapy. These services are intended to promote relaxation, improve mobility, and support overall wellness. I acknowledge that these services are not a substitute for medical care and are not intended to diagnose, treat, or cure any medical conditions.
Risks and Responsibilities I understand and acknowledge the following:
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Stretch Therapy: This involves manual stretching techniques that may result in mild soreness or discomfort. I agree to communicate any pain or discomfort during the session.
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Myofascial Release: This technique involves pressure applied to fascia and muscles. Minor bruising or temporary soreness may occur.
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Cupping Therapy: This may leave temporary discoloration or marks on the skin. I understand this is a normal reaction and not harmful.
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Kinesiology Taping: The tape is designed to support muscles and joints. I will notify the provider if I experience skin irritation or an allergic reaction.
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Graston Technique: This instrument-assisted technique may cause temporary redness, bruising, or discomfort.
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Theragun Therapy: Percussive therapy may cause mild discomfort. I agree to inform the provider if the intensity is too strong.
I understand that results are not guaranteed and that my response to these services may vary. I agree to provide accurate information about my health history and to notify my provider of any changes to my medical status.
Medical Clearance and Contraindications I certify that I have no medical conditions or contraindications that would prevent me from safely participating in these services. I have disclosed all relevant medical history, including but not limited to:
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Cardiovascular issues
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Blood clotting disorders
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Skin conditions
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Recent injuries or surgeries
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Pregnancy
Release of Liability I voluntarily agree to assume all risks associated with the services provided. I release Latitude Movement, its owner, and any associated personnel from any liability for injury, loss, or damages resulting from my participation in these services, except in cases of gross negligence or willful misconduct.
Payment and Cancellation Policy I understand that payment is due at the time of booking or service. I agree to provide at least 24 hours' notice for cancellations. Late cancellations or no-shows may be subject to a fee.
Consent to Treatment By signing below, I confirm that I have read and understood this Liability Waiver and Informed Consent Form. I have had the opportunity to ask questions and have received satisfactory answers. I voluntarily consent to receive the services provided by Latitude Movement.