Cancellation Policy

 

If your cancellation is at least 24 hours in advance of the session, you will not be charged/will receive a full refund. If your cancellation is less than 24 hours in advance, the session must be paid for in full. Exceptions can be made for extenuating circumstances or with the approval of the therapist. Please contact The Symmetry Clinic at 801-857-4912 in the event that you cannot attend your session to discuss specifics.

 

Terms & Conditions

 

I understand that the massage therapist is providing massage therapy services within their scope of practice as defined by the Massage Therapist Association and the Utah Department of Public Licensing. 

 

I hereby consent for my therapist to treat me with massage therapy for the above noted purposes including such assessments, examinations and techniques, which may be recommended, by my therapist. 

 

I acknowledge that the therapist is not a physician and does not diagnose illness or disease or any other physical or mental disorder. I clearly understand that massage therapy is not a substitute for a medical examination. It is recommended that I attend my personal physician for any ailments that I may be experiencing. I acknowledge that no assurance or guarantee has been provided to me as to the results of the treatment. I acknowledge that with any treatment there can be risks and those risks have been explained to me and I assume those risks. 

 

I acknowledge and understand that the therapist must be fully aware of my existing medical conditions. I have completed my medical history form as provided by my therapist and disclosed to the therapist all of those medical conditions affecting me. It is my responsibility to keep the massage therapist updated on my medical history.  The information I have provided is true and complete to the best of my knowledge. 

 

Our clinic is committed to upholding HIPAA standards and safeguarding the privacy of all patient information. We assure you that no personal data will ever be sold or utilized for purposes beyond clinic operations without prior written consent. While we employ software solutions for enhanced efficiency, it's important to note that some of these platforms may involve storing information on the cloud, which may not always align perfectly with HIPAA standards. However, we pledge to diligently evaluate and select software providers that prioritize data security and privacy to the best of our abilities. Rest assured, every effort will be made to maintain the confidentiality and integrity of your sensitive information within the bounds of regulatory compliance.

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I have read the above noted consent and I have had the opportunity to question the contents and my therapy. By signing this form, I confirm my consent to treatment and intend this consent to cover the treatment discussed with me and such additional treatment as proposed by my therapist from time to time, to deal with my physical condition and for which I have sought treatment. I understand that at any time I may withdraw my consent and treatment will be stopped. If a dispute arises, between myself and my therapist or The Symmetry Clinic, the parties have agreed to submit to binding arbitration to resolve the dispute.