Massage intake form
We love creating personalised experiences for you.
Sharing more about yourself helps us create something unique to you as we take into consideration your needs.
Mirosuna wants to support you to create space for change. We welcome you to find more meaning in your everyday life through our multi-sensory relaxation experiences.
1. Mirosuna is not a medical organisation, and its practitioners cannot give you medical advice or diagnosis. All suggestions and comments relating to the use of equipment, poses, moves and instruction are exactly that, suggestions, you are not obliged to do anything, and the actions that you carry out are undertaken at your election.
2. You understand that it is your responsibility to judge your physical and mental capabilities and to ensure that when participating in any session, that you will not exceed your limits. You acknowledge that you will select the appropriate level of exertion for your skills and abilities, as well as for any mental or physical conditions and/or limitations you have. You understand that from time to time the Mirosuna team may suggest physical adjustments or the use of equipment and it is your sole responsibility to determine if this is appropriate for your level of ability and physical and mental condition. You expressly waive and release any claim that you may have at any time for an injury of any kind against Mirosuna, or any person or entity involved with Mirosuna.
3. In participating in our sessions, you acknowledge, agree and represent that you understand the nature of the session in which you are choosing to participate, you are in good health and in proper physical condition to participate in such activities and you further agree and warrant that if at any time you believe conditions to be unsafe, you will immediately stop further participation in the activity.
4. In consideration for being allowed to participate in our sessions, in addition to the payments, fees and charges that you have paid, you waive, release, and forever discharge Mirosuna and its related entities from any and all responsibilities or liability from injuries or damages resulting from your participation in such activities and programs. By this waiver, you assume any risk, and take full responsibility for and waive any personal injury, death, damage, or loss of personal property associated with your sessions, including but not limited to using our studio or our equipment, participating in our sessions or other related activities on and off our premises.
5. If you experience pain or discomfort during the session, you agree to immediately inform your therapist so that pressure/strokes can be adjusted to your level of comfort. You agree not to hold Mirosuna responsible for any pain or discomfort that you experience during or after the session.
6. You understand that our service is entirely therapeutic and non-sexual in nature.
7. You affirm that you have stated all known medical conditions, and answered all questions honestly. You agree to keep the Mirosuna updated as to any changes in your medical profile and understand that there shall be no liability on Mirosuna’s part should you fail to do so.
8. You agree that you have read, understood and fully agree to the terms of this waiver and release, and you understand and confirm that by signing this waiver and release, you are giving up considerable future legal rights.