BETTER HEALTH CHIROPRACTIC LOCATION: 1955 LAPORTE RD, WATERLOO
TRANSCEND FLOAT CLINIC LOCATION: 409 WASHINGTON ST, CEDAR FALLS
Prior to each therapy session, a treatment plan will be discussed with you. At your first visit you will be asked to sign this consent stating that you have read the information, understand it, and agree to comply with the professional therapy policies and procedures. A copy will be provided to you upon request. Patients who have not been seen for a year or more will also be asked to sign a new consent.
Sarayu Wellness is committed to provide the highest quality Massage and Bodywork therapies. We are happy to adjust pressure, temperature, music choice and volume level. In order to best meet the needs of each individual, each treatment is customized just for you. We will be happy to work specific areas, work longer on an area or move on as you request. Communication between therapist and patient is necessary in order to provide you with the best experience.
Patient/Therapist trust is a must. It is important that you feel safe to share any information. All information, medical or personal, shared by the patient will be treated as confidential. Information gathered will only be shared with written consent. A release of information is required prior to sharing any portion of a patient file with other medical professionals.
During the therapy treatment, patients may choose to leave on as much clothing needed for comfort. Patients may refuse any treatment methods and stop the therapy at any time. The therapy door is never locked and patients are free to leave. Patients will always be modestly draped. Only the area being worked will be undraped.
It is the responsibility of the patient to inform the therapist of any current medical conditions or treatments occurring and also provide a list of medications and herbal supplements you are currently taking. In some instances, you may be required to provide written permission from a physician, chiropractor, or any other medical professional involved in treatment of healthcare. The patient must keep the therapist informed of any changes in health conditions.
An involuntary emotional or sensual response to bodywork can happen. This is a natural occurrence and will subside. Sexual interaction or discussion of any kind between the patient and the therapist is never appropriate. Requests for sexual activity will not be tolerated. Such behavior will be viewed as a solicitation and reported to the proper authorities. If this occurs, the treatment will end immediately and the patient will not be rescheduled.
It is our commitment to provide an outstanding and customized experience to all patients. Out of consideration for your therapist, we have adopted the following policies:
- PLEASE ARRIVE FOR YOUR APPOINTMENT 15 MINUTES PRIOR TO YOUR SCHEDULED START TIME. THIS ALLOWS YOU THE TIME TO FILL OUT ANY FORMS AND PREPARE FOR THE THERAPY SERVICE. ALL BODYWORK THERAPIES HAVE A SPECIFIC TIME SCHEDULE. ARRIVING EARLY ALLOWS FOR A RELAXED AND UNHURRIED EXPERIENCE. IN THE EVENT OF A LATE ARRIVAL, YOUR SERVICE MAY BE SHORTENED IN ORDER TO START THE NEXT SCHEDULED APPOINTMENT ON TIME. THE ORIGINAL TREATMENT PRICE WILL BE CHARGED.
- PLEASE PROVIDE AT LEAST 24 HOURS NOTICE IF YOU NEED TO CANCEL OR RESCHEDULE YOUR APPOINTMENT. THIS GIVES THE THERAPIST AN OPPORTUNITY TO FILL THE TIME SLOT. IF A PATIENT FAILS TO CANCEL WITHIN 24 HOURS MULTIPLE TIMES, YOU WILL BE ASKED TO PRE-PAY FOR FUTURE SERVICES
PATIENTS WHO FAIL TO SHOW FOR APPOINTMENTS MAY BE ASKED TO PRE-PAY FOR FUTURE SERVICES. IT IS IMPORTANT THAT YOUR THERAPIST IS COMPENSATED FOR THEIR VALUABLE TIME SET ASIDE JUST FOR YOU.
I HAVE READ AND FULLY UNDERSTAND THIS CONSENT FORM. I AGREE TO COMPLY WITH ALL POLICIES STATED