Informed Consent Form

– I (Client) have chosen to consult with Kůra Růka and hereby give consent for Ayurvedic Yoga Massage/Dynamic Thai Massage therapy (Therapy, Massage therapy) to be provided by Raphaël Beaupied (Therapist, Massage therapist) who I understand is a practitioner accredited by the ARYM Institute (Mysore, India) and Blue Garden (Chiang Mai, Thailand).

– I have filled the required massage intake form and do not expect the massage therapist to have foreseen any previous or pre-existing medical condition that I have not mentioned.

– I understand that massage therapy may provide benefits for certain conditions but that lasting results are not guaranteed. These benefits may include relief of muscular tension, relaxation, reduction in the symptoms of stress-related conditions and provision of general wellbeing.

– I also understand that massage therapy may produce expected side effects such as muscle soreness, increase awareness of areas of pain and light-headedness amongst other possible temporary outcomes.

– I acknowledge that the massage therapist cannot diagnose, treat or prescribe any type of physical or mental conditions nor can the services provided be a substitute for consulting with a licensed physician or other health care professional.

– I understand that relevant body parts will be draped accordingly during certain sections of the therapy to ensure that there is no indecent exposure.

– I understand that I may experience emotional releases, intestinal gas or eructations during the therapy, which are a natural, normal response from the body.

– The massage therapist understands that I have the right to question procedures used and to receive an explanation of any manipulations that the therapist performs.

– I will inform the therapist about any discomfort I may experience during the session and understand that the massage therapy will be adjusted accordingly. I am informed that I have the right to terminate the therapy at any time if such discomfort persists.