Client Information Privacy
All information provided by the client (e.g. submitted documentation via written form or electronic communications, verbally shared information during treatment) is considered confidential and will not be released without his/her written consent or unless required by law.
Payment: Full payment is expected at the time of service. Accepted forms of payment include cash, personal check, or credit/debit cards (Visa, Master Card, Amex, and Discover). Fees for returned checks may be charged according to Florida law. Mitchell Diaz, LMT does not accept or bill insurance.
Cancellation: A 24-hour notice is required for cancellation of an appointment, or you will be charged in full for the appointment. Payment is due before your next appointment.
Tardiness: Appointment times are as scheduled and cannot extend beyond the stated time to accommodate late arrivals. You will be charged the full fee for your appointment regardless of how much time is left. To enjoy the full benefits of your session, please be on time to your appointment.
Sickness or Personal Emergencies: Massage/bodywork is not appropriate care for infectious or contagious illness. Please cancel your appointment as soon as you are aware of an infectious or contagious condition. If it is within the 24-hour notice period, the cancellation fee may be waived. Cases of extreme personal emergencies may also be considered as exceptions at the sole discretion of the massage therapist.
Consent for Treatment
If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage/bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware. I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such. Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner’s part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment. Understanding all of this, I give my consent to receive care.
At your first visit, you will be required to complete important paper work regarding your current and past health history. Download now…