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therapists and/or with other office or clinic personnel, the nature of massage therapy treatment and other procedures. I understand the results may not be guaranteed. </div><div class="desc" data-v-98e15920> I am informed that, as in all health care, in the practice of massage therapy there are some very slight risks to treatment, including, but not limited to, muscle strains and sprains, bruising, light headed or dizziness, and tenderness. I do not expect the massage therapist to be able to anticipate and explain all risks and complications and I wish to rely on the massage therapist to exercise judgment during the course of the treatment which the massage therapist feels at the time, based upon the facts then known, and is in my best interests. </div><div class="desc" data-v-98e15920> I understand that I will be draped at all times and the areas undraped will be secure to insure there is no indecent exposure. If undraping my gluteals is significant in the treatment I do understand that it is part of the therapy. </div><div class="desc1" data-v-98e15920> I am informed that have the right to terminate the treatment at any time, and the right to alter the therapist&#39;s pressure during the massage treatment. </div><div class="desc" data-v-98e15920> I am aware there are further alternatives offered such as osteopathic manipulation treatment, acupuncture, kinesiology taping, and physical therapy etc. </div><div class="desc" data-v-98e15920> I have read the above consent. I have also had an opportunity to ask questions about its consent, and by signing below, I agree to the above named procedures. I intend this consent form to cover the entire course of the treatment for my present condition and for any future condition(s) for which I seek treatment. </div><div class="desc1" data-v-98e15920>Cancellation and No Show Policy</div><div class="desc" data-v-98e15920> The clinic has a 24 hours cancellation and no show policy. Patients must notify the reception more than 24 hours prior to an appointment. Failure to do so will result in a full treatment cost as booked cancellation and no show fee. </div>',9),I={class:"Description_box"},C=a((()=>u("div",{class:"Date_title"},"Date:",-1))),P={class:"Description_box",style:{"align-items":"flex-end"}},T=a((()=>u("div",{class:"Legal_Guardian"},"Patient Signature (Legal Guardian)",-1))),q=["src"],B={class:"Description_box",style:{"align-items":"flex-end"}},F=a((()=>u("div",{class:"Legal_Guardian"},"Witness of Signature",-1))),H=["src"],N={key:1,class:"formDialog_box"},E=a((()=>u("div",{class:"title5"}," Consent for Assessment and Treatment of Sensitive Areas ",-1))),X={class:"input_box",style:{"margin-top":"30rpx"}},G={class:"treated_desc_box",style:{margin:"25px 0 30px 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Signature:",-1))),W=["onUpdate:modelValue"],Z=["src"],L=["onClick"],$=a((()=>u("div",{class:"desc1"},"List Clinical Indication:",-1))),ee=f('<div class="desc1" data-v-98e15920> The RMT has explained the following to me and I fully understand the proposed assessment and/or treatment: </div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920> The nature of the assessment, including the clinical reason(s) for assessment of the above area(s )and the draping methods to be used </div></div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920>The expected benefits of the assessment</div></div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920>The potential risks of the assessment</div></div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920> The potential side effects of the assessment </div></div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920>That consent is voluntary</div></div><div class="yuan_box" data-v-98e15920><div class="yuan_k" data-v-98e15920><div class="yuan" data-v-98e15920></div></div><div class="yuan_desc" data-v-98e15920> That I can withdraw or alter my consent at any time </div></div><div class="desc1" data-v-98e15920> I voluntarily give my informed consent for the assessment and/or treatment as discussed and outlined above. </div><div class="desc1" data-v-98e15920>Client Name 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