**Read all terms and conditions before submitting Intake form**
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402-670-0707
Note to Client: Jodie is visually impaired so communication with her is very important.
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terms and conditions
I understand that massage is NOT a substitute for medical treatment.
Any sexual remarks or advances will terminate the session and I (the person receiving the massage) am liable for payment.
I, for myself, and on behalf of my heirs, executers, administrators, or personal representatives, hereby waive, release, discharge, and hold harmless Ambassador Wellness Center, LLC (the facility Jodie Kreifels uses for massages), its members, officers, employees, and agents from any and all liability for any and all injuries, including death, damages or claims relating to or resulting from my receipt of the services, now or in the future, foreseen or unforeseen. Further, I will indemnify and hold Ambassador Wellness Center, LLC, it's members, officers, employees, and agents harmless from and against any and all claims, rights, damages, liabilities, losses, cost and expenses (including reasonable attorney's fees) arising from or in connection with any injuries to to other persons or damage to property cause or attributed to me.
I, hereby, give my consent to receive massage services and/or other bodywork or treatment (the "services") from Jodie Kriefels, and I acknowledge and agree that I am doing so at my own risk. My health and safety with respect to such services are my sole responsibility, I acknowledge that my receipt of the services from Jodie Kreifels may result in bodily injury to me or my death. My decision to receive services from Jodie Kreifels is voluntary, and I know of, understand and assume any and all risks associated therewith.
I understand that I will need to update my therapist on my health and well being prior to each session.
Being that a massage should NOT be done under certain medical conditions, I affirm that I have answered all questions truthfully.
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