Client Forms

Informed consent & liability release

Plain language about what massage therapy is, what it isn’t, your rights during every session, and what you’re agreeing to. Read it on screen, print it, or sign it with us at your first visit.

Download this form (PDF)

Intake & health history Care-coordination form

Bourne Bodyworks · 818 Industry Place, Carbondale, CO 81623 · (970) 355-8790 · bournebodywork@gmail.com

Client information

 
 
 

What massage therapy here is — and is not

Massage therapy at Bourne Bodyworks — sports massage, longevity massage, and craniosacral therapy — is manual soft-tissue work performed by a massage therapist licensed by the State of Colorado. It can ease muscle tension, support recovery and training, and improve comfort and mobility.

It is not the practice of medicine, chiropractic, or physical therapy. The therapist does not diagnose illness or injury, does not prescribe or adjust medication, and does not treat medical conditions — where a client is under a provider’s care, the massage work coordinates with that care, never directs it. Massage is a complement to medical care, never a substitute for it. If something appears to need a physician, the therapist will say so and refer out.

Your rights in every session

  • You are in charge. You may ask to change the pressure, skip an area, pause, or end the session at any time, for any reason.
  • Draping is standard. You will be professionally draped with sheets at all times; only the area being worked is undraped. You may keep on any clothing you prefer.
  • Boundaries are absolute. This is strictly therapeutic, non-sexual work. Inappropriate conduct or language ends the session immediately — and either the client or the therapist may end a session on those grounds.
  • Speak up. Tell the therapist about pain, discomfort, or anything that doesn’t feel right the moment you notice it — adjusting is always the right call.

Your responsibilities

  • Complete the intake & health history form honestly and fully — the safety of the work depends on it.
  • Tell the therapist about changes in your health, medications, injuries, or pregnancy status before each session.
  • Follow any activity or self-care guidance at your own discretion — and direct medical questions to your physician.
  • For in-home sessions: provide a reasonably clear, safe working space and secure pets during the session.

Known risks

Massage is low-risk, and honest work names the risks anyway: temporary soreness, redness, or light bruising after deeper work; short-lived lightheadedness after a session; rare skin reaction to oils or lotions; and — rarely — aggravation of an existing injury or condition, which is why full health disclosure matters. Craniosacral work is very light-touch, and can occasionally bring a temporary emotional release, a brief flare of existing symptoms, or short-lived drowsiness or disorientation after a session. If I experience unexpected pain or symptoms after a session, I will contact the therapist and, when appropriate, my physician.

Consent & release of liability

I voluntarily consent to receive massage therapy from Bourne Bodyworks LLC. I have read this form, had the chance to ask questions, and understand the scope of the work and its known risks, including those tied to any health conditions I have disclosed. I voluntarily assume the known and inherent risks of massage therapy described above.

In consideration of receiving massage therapy, I release and hold harmless Bourne Bodyworks LLC and its members, owners, employees, agents, and contractors (together, the “Released Parties,” including the therapist named below) from claims, injuries, or damages arising from the inherent risks I have assumed above, or from my failure to disclose relevant health information. This release does not waive claims based on negligence — and under Colorado law, gross negligence and willful misconduct cannot be waived. Nothing in this release limits any right that Colorado law does not permit to be limited.

This consent covers today’s session and future sessions until I revoke it in writing — email to bournebodywork@gmail.com is sufficient, and revocation takes effect when received. If my health changes materially, I will tell the therapist before the next session, and we will update this form and initial-and-date the change (or re-sign) before further hands-on work.

This form is governed by Colorado law. If any part of it turns out to be unenforceable, the rest stands.

Policies I’m acknowledging

  • Cancellation: a card holds your appointment. 24 hours’ notice reschedules free of charge; inside 24 hours the session is billed in full. I authorize Bourne Bodyworks to charge my card on file (or apply my deposit) for late cancellations and no-shows under this policy.
  • Privacy: my health information is confidential and handled as described in the privacy page; it is shared with another provider only with my separate written consent on the care-coordination form.
  • Lateness: sessions end at the scheduled time so the next client starts on time; a late start shortens the session, not the fee.

Signatures

 
 

If the client is under 18

 
 
 

During my child’s session I will:  ☐ remain in the treatment room   ☐ remain on the premises
In an emergency, I authorize the therapist to call 911 and my child’s emergency contact.  ☐ yes

 
 
 

How this gets signed. For adults, this consent and release is sent to you as an e-signable form by email before your first session — you read it and sign it online, and both of us keep a copy. Our booking calendar cannot capture a signature, so booking online is never treated as signing this. Anyone under 18 signs this on paper, at the first visit, with a parent or guardian present. This printed version stays available for that, for in-home sessions, and for anyone who would simply rather sign on paper.

Note for the practice owner: this is general template language for demonstration only — remove this note only as part of attorney sign-off, never before. Have a qualified attorney review it against Colorado’s requirements for exculpatory agreements (including whether to release ordinary negligence for adults under Jones v. Dressel, and for minors under C.R.S. § 13-22-107), consent, and scope of practice. Signed forms should be stored with the client’s intake records in a locked file or secure clinical system.

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