Stretch Center Treatment Consent Form

Stretch Center Treatment Consent Form – Rockford, IL

Date

First Name

Last Name

Prior to receiving treatment, I have been candid in revealing any condition that may have bearing on this therapy.
I understand there are no guarantees as to the result of any treatment, due to many variables, and in order to achieve maximum results, I may need several treatments.
I understand that although complications are very rare, sometimes they may occur and that prompt treatment is necessary. In the event of any complications, I agree to immediately contact the staff member who performed the treatment.
I understand that I should follow my clinician’s recommendations for post stretching session to minimize side effects and maximize results..

By clicking this box and entering my name in the signature field below, I am agreeing to the previous statements

Patient Name (signature)