Massage Treatment in the Era of COVID-19

As with the transmission of any communicable disease, like colds or flu, it is possible to be exposed to COVID-19, also known as “Coronavirus”, at any time or in any place. Be assured that we follow state and federal regulations and recommendations on disinfecting protocols and have available personal protective equipment to limit transmission of all diseases in our office.

Disinfecting protocols are completed after each client.

Despite our careful attention to disinfecting protocols, there is still a chance that you could be exposed to an illness in our office, just as you might be at your gym, grocery store, or favorite restaurant.

“Social distancing” nationwide has slowed the transmission of the Coronavirus. Although we have taken measures to provide social distancing practices in our clinic, due to the nature of the procedures we provide, it is not possible to maintain social distancing between the client, and the Massage Therapist, and sometimes other clients at all times.

In order to social distance as much as possible, I ask:

COVID-19 Information & Liability Waiver

COVID-19 Information

Consent for Treatment

I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.

Typing your name in the box below represents your digital signature on this form.

COVID-19 Pre-Screening

By attending my appointment…
I agree that I am not currently experiencing any of these symptoms:

Please note: Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea. 

I agree that I have not:

If you have experienced any of the above, please reschedule your appointment at least 14 days from now.

If I have tested positive for Covid-19, have quarantined and recovered, I will have taken a Covid-19 test and have a negative result before going to the appointment.

If I have received vaccinations, I will provide vaccination dates to my practitioner at the time of appointment to be entered into my Health Chart.

Contact Us

Center for Life Design
684 Excelsior Blvd, Ste 120
Excelsior, MN 55331