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I understand that I am voluntarily receiving a chair massage from Katie Winslow, a licensed massage therapist.

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I acknowledge that chair massage is a therapeutic service and is not a substitute for medical treatment or diagnosis.

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I understand that it is my responsibility to inform the massage therapist of any medical conditions, injuries, or concerns before receiving the massage.

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I acknowledge that the massage therapist will discuss any discomfort or pressure during the massage, and I have the right to request adjustments or stop the massage at any time.

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I understand that the massage therapist is not liable for any injuries or accidents that may occur during or as a result of the chair massage session.

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I acknowledge that the massage chair has a weight limit of 300 lbs, and I confirm that I do not exceed this weight limit. I understand that I will be liable to pay for any damages to the chair if I exceed this weight limit.

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I have read and understood the above information, and I voluntarily consent to receive a chair massage from [Therapist's Name].

Name - Typing your name here will act as your signature on file. *

First Name

Last Name

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