I have completed this form to the best of my ability and knowledge and agree to inform my therapist and/or technician if any of the above information changes at any time. I will inform the therapist and/or technician of any discomfort I may experience at any time during my treatment to allow them to adjust accordingly. The treatments I receive are voluntary and I agree to waive all liabilities towards my therapist, my technician and Melt Spa and Massage for any injury or damages incurred due to any misrepresentation of my health history. By submitting this form, I affirm my acceptance of these terms.   

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