I consent to allowing the Cupping Practitioner / Massage Therapist to perform Cupping Therapy. I understand the benefits, side effects, contraindications, and the possibility of cupping marks as part of the massage and will not hold the Massage Therapist responsible. I have asked all necessary questions and have had any concerns addressed. I understand that my Massage Therapist does not diagnose nor treat any illness, nor prescribe any medical treatment. I understand it is important that complex, current and accurate information about my health status be relayed here, as there are conditions in which massage may be contraindicated. It is my responsibility as the client to keep my therapist informed of any changes in my health status. This assumption of risk, release, waiver of liability and indemnification agreement is given to Massage Therapist and Body Balance, in exchange for rendering massage services, and performing cupping, and I agree that this assumption of risk, release, waiver of liability and indemnification shall apply at each visit.

After your Cupping Therapy session, please remember to check for all belongings. Body Balance is not responsible for any lost items left in the spa.