I hereby request and consent to the therapy/class provided by the Physiotherapist, trained personnel under their supervision or instructor.
I will have the opportunity to discuss the nature, purpose and type of therapy/class provided with the therapist/instructor during my initial assessment/meeting at the clinic.
I further understand and am informed that, as in all health care, there are some risks to treatment/classes, including but not limited to, muscle sprains and strains, soreness, increased discomfort and strokes. I do not expect the therapist/instructor to be able to anticipate and explain all risks and complications and I wish to rely on the therapist/instructor to exercise judgment during the course of the procedure which he or she feels at that time, based upon the facts then known, and is in my best interest.
Payments are the client’s responsibility, and will be billed at each visit. I understand that I am financially responsible to Kinetic Physiotherapy/Kinetic Yoga & Pilates for all charges.
I have read the above consent and by checking below I agree to the above.