Please answer thoroughly. It is very important that you disclose any conditions related to your:

• Respiratory system (e.g. asthma, chronic cough)

• Digestive system (e.g. ulcers, IBS)

• Skin (e.g. rashes, infections, sensitivities)

• Circulatory system (e.g. high/low blood pressure, varicose veins)

• Neurological system (e.g. migraines, seizures)

• Musculoskeletal system (e.g. joint issues, past injuries)

• Reproductive health, including pregnancy, menopause, or hormonal therapy

• Mental health conditions that may impact your comfort or experience during treatment

If none apply to you, please write "N/A".

This information is required to ensure your session is safe, comfortable, and appropriately tailored to your needs.

GENERAL SERVICE AGREEMENT

• Honesty and Accuracy: I affirm that all information I have provided in this form is honest and accurate. I accept that I will not hold the students, instructors, and the school liable for any issues arising from inaccuracies or untruths on this form.
• Treatment Process: I am aware that the therapist is required to assess, ask questions, and create a treatment plan based on my health needs.
• Privacy in Public Locations: I acknowledge that sessions may be conducted in public areas where conversations could be overheard. I release Thrive RMT, its staff from liability should any of my personal information be disclosed during these sessions.
• Right to Terminate Treatment: I understand that the therapist has the right to stop treatment if I exhibit violent or inappropriate behavior.
• Photography for Marketing: I am informed that the Thrive RMT may take photos for social media marketing and promise that images including faces will only be used with explicit consent. 
• One Session per Participant: I understand that I am allowed only one treatment session per event.
• Late Arrival Policy: If I am late by 5 to 10 minutes, my slot may be given to the next person, and I may need to reschedule or wait accordingly.
• Equipment Availability: I understand that available equipment, whether a chair or a table, at my timeslot is what will be provided, with no alternative options.
• Immediate Feedback on Discomfort: I agree to promptly notify my therapist if I experience any pain or discomfort during the treatment.
• Separate Consent for Sensitive Areas: I understand that treatment of the glutes, chest, inner thighs, and breasts requires separate consent. I will provide my initials to signify my agreement to such treatments, ensuring it is deemed appropriate and consent has been properly obtained by the therapist
• Adaptability to Oral Rules: I accept that oral rules may be added to this consent form as necessary, based on the specific scenario and situation of the outreach. The rules will be reasonable and introduced on the spot.
• Release of Liability: By signing, I agree to release Thrive RMT, its staff of the National Institute from any past, present, and future liabilities.