Yellow Blue Moon Inc. d/b/a Mudras (“Practitioner” or “Mudras”) is a fully licensed massage therapist and body work provider (the “Services”). The Services may not be appropriate with certain medical conditions and a referral from your health care provider may be required prior to service being provided. If you have a serious medical condition, it is recommended that you consult with your health care provider prior to receiving the Services. I understand that the Services l receive (the “Session”) are provided for the purpose of relaxation and relief of muscular tension.
I hereby give my consent to receive the Session and acknowledge that I am doing so at my own risk. I acknowledge that I have had the opportunity to ask questions about the Session. If l experience any pain or discomfort during the Session, l will immediately inform Practitioner. I further understand that the Session is not a replacement for medical care and should not be construed as a substitute for medical examination, diagnosis, advice or treatment.
l understand that nothing said in the course of the Session given should be construed in any way as medical advice or the substitute for medical advice. I affirm that l have stated all my known medical conditions, fully answered all questions to the best of my ability, and I have disclosed any medical or mental condition that may prevent me from receiving the Services prior to receiving the Session. Mudras may, at its sole discretion refuse or discontinue the Session should the Practitioner determine that it is unsafe or that I have engaged in inappropriate conduct.
I hereby release and agree to defend, indemnify and hold Mudras, its landlord, CPM Enterprises LLC d/b/a Drive 495, and both of their respective directors, officers, employees, contractors, agents and representatives harmless from any and all claims, damages, loss, liabilities, judgments, costs and expenses (including attorney fees and costs) arising out of or in any manner connected with the Services, except as may result from gross negligence or willful misconduct.
I agree to be bound by these terms and conditions.
We will use your email address for appointment reminders, promotions and news from Mudras. Your privacy is important to us. We will not sell, rent or give your name or address to anyone without your consent.
In the event I cancel or miss an appointment with less than 48 hours’ notice, I authorize Mudras to charge me for 50% of the session fee. In the event I cancel or miss an appointment with less than 24 hours’ notice, I authorize Mudras to charge me for the full session fee.