Informed voluntary consent to the procedure of manual massage, hardware massage, body wraps.
I report that:
I don't have allergic reactions to anything;
I am not currently taking any medications;
I'm not pregnant;
I have no gynecological problems;
I don't have chronic diseases.
I confirm that I have been informed about the existing contraindications to massage:
Absolute contraindications:malignant tumors; gangrene; thrombosis; active form of tuberculosis; venereal diseases; acute and chronic osteomyelitis; causal syndrome after injury of peripheral nerves; circulatory failure and heart failure of the 3rd degree; angiitis (disease of small blood vessels); diseases with severe mental changes; aneurysms of blood vessels, aorta; scurvy; HIV infection; blood diseases, tendency to bleeding; atherosclerosis of peripheral vessels, thromboangiitis in combination with atherosclerosis of cerebral vessels, pregnancy, lactation.
Relative contraindications:Acute febrile conditions; acute inflammatory process; bleeding; purulent, infectious processes (furunculosis, etc.); lymphadenitis, lymphangitis; crises: hypertensive, hypotonic and cerebral; multiple allergic skin rashes, as well as hemorrhages and swelling; nausea, vomiting, abdominal pain; alcohol intoxication; acute pain requiring narcotic analgesics; acute cardiovascular, renal failure; acute illnesses and infections; menstruation; intoxication; bleeding of any kind.
I confirm that this document has been read and explained to me, its content is clear to me. The information received is enough for me to give this informed and informed consent to the procedure of manual massage, hardware massage, wrapping.
ATTENTION!!!
1. Provide a valid WhatsApp number for feedback and consultations _____________________________.
(whatsapp number)
2. The paid cost of the procedures is non-refundable, you have the right to replace the procedures you have chosen with others according to the total cost of the deposited amount.
"____" _____________ 20__
___________________________________________________________________________
(signature of the patient) - last name, first name, patronymic in full)
Specialist:_______________________________________________________