Intended Health Benefits Acknowledgment Form

Tranquil Moments Massage Therapy

Our goal is to support health, relaxation, and well-being through professional massage therapy. While massage offers many potential benefits, individual results will vary

Massage therapy may contribute to:

✔ Reduced muscle tension and physical discomfort

✔ Improved circulation and flexibility

✔ Enhanced relaxation and stress management

✔ Support for improved sleep quality

✔ Temporary relief from pain or stiffness

✔ General support for physical and mental well-being

By signing this form, I acknowledge the following:

✔ Massage therapy is not a substitute for medical treatment or diagnosis.

✔ The benefits listed are not guaranteed; every individual responds differently.

✔ I will notify the therapist of any discomfort, concerns, or changes in health.

✔ I have disclosed relevant medical history, medications, or recent injuries that may affect the session.

✔ If I experience any adverse effects following treatment, I will seek appropriate medical advice.

Section B — Minor Clients

I am the parent or legal guardian of the minor listed above and hereby give my consent for the minor to receive massage therapy services. I acknowledge the intended benefits and limitations outlined in this form.

Section C — Corporate Participants