COVID-19 Massage Therapy Treatment Consent Form

To receive care, I confirm and understand the following:

I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). I further understand that COVID-19 is extremely contagious and may be contracted from various sources. I understand COVID-19 has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.

I understand that preventative measures and intensified sanitation protocols intended to reduce the spread of COVID-19 have been implemented. However, because massage therapy involves close physical proximity over an extended period of time in a closed space, there may be an elevated risk of disease transmission, including COVID-19. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this treatment and give my express permission to the practitioners and staff at Living Light Massage to proceed with providing care.

I agree that I will notify Living Light Massage if I test positive for COVID-19 and have received a massage in the last 14 days. I understand in the event this happens, my contact information may be shared with the Department of Health and other entities as needed.

Living Light Massage complies with contact tracing efforts, working with the Department of Health and other entities as needed. I agree that my contact information may be shared with the above entities if a case of COVID-19 is identified in a client, therapist or employee and appointment records indicate you may have been exposed to said person while they were infected.

By signing this form, I knowingly and willingly consent to receiving massage therapy treatment with the full understanding and disclosure of the risks associated with receiving care during the COVID-19 pandemic. I appreciate that it is not possible to consider every possible complication to care. I intend this consent to cover the entire course of care from all the practitioners at Living Light Massage.
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