Clinical Photos & Communication Consent

Required Field

Clinical Photos & Documentation (Required)

Clinical photos and/or videos (such as posture assessment, movement screening, or self-care exercise demonstrations) may be taken as part of your treatment. These images are used to document your condition, support clinical assessment, guide treatment planning, and track progress over time.
These materials become part of your confidential clinical record and are handled in accordance with applicable privacy laws.

Optional Use for Education, Marketing, or Public Materials

Non-identifiable photos or videos may be helpful for professional education, workshops, case studies, website content, or social media.

Communication Preferences (Optional)

Your care is not dependent on selecting any of the options below.

Email (E-Newsletter & Updates)

I would like to receive occasional emails from Yaima Massage & Movement, PLLC, including wellness tips, service announcements, schedule updates, and special promotions. You may unsubscribe at any time by using the unsubscribe button included in each e-newsletter.

Text Messages (SMS)

I would like to receive text messages from Yaima Massage & Movement, PLLC, including appointment reminders, schedule changes, announcements, and promotional offers. Message frequency may vary. Standard message and data rates may apply. You may opt out at any time by replying STOP.

Clinical Photos & Communication Consent
Personal Info