General Waiver Information
Updated: 4 January 2022
All new clients will be sent the below as a Client Waiver Form via the automated appointment confirmation function of the Patient Management System utilised by Restore Prehabilitation & Wellness Ltd, trading as Restore Prehabilitation & Recovery.
All clients will be required to complete the form 48 hours prior to their initial appointment. By not completing the below, Restore Prehabilitation & Recovery and its practitioners holds the right to refuse delivery of service.
- I understand that all services are provided for injury resolution, injury mitigation, stress reduction, relaxation, relief from muscular tension, and improvement of circulation and range of motion
- If I experience pain or discomfort during the session, I will immediately inform my practitioner so that effort can be adjusted to my level of comfort. I will not hold my practitioner responsible for any pain or discomfort I experience from the session
- I affirm that I have notified my practitioner of all known medical conditions and injuries via the intake form and prior to any session if my situation changes between times.
- I agree to inform my practitioner of any changes in my health and medical condition. I understand that there shall be no liability on the instructors part should I forget to do so.
- I understand that all services are designed to assist in greater mobility and movement gains and are non-sexual in nature.
- I understand that there is a service specific cancellation policy. If I am unable to cancel before that time, I will be responsible for the costs associated with that session. This includes late arrival of 10 minutes or more to a scheduled appointment.
- I understand that all invoices, including late cancellation invoices, are to be paid on the day of issue. All outstanding payments over 7days, will incur interest of 18% of the total outstanding values on a daily basis and collected by a third party.
- I understand that the services offered today are aligned with the practitioner’s scope of practice and may not be a substitute for additional medical care or diagnosis.
- I understand that my practitioner is not qualified to perform spinal or skeletal adjustments, prescribe medication, or treat mental illness.
Further Information and Agreement
- Prior to your session, please remove jewellery or watches. Pull long hair back with a band.
- Please wear loose, long, comfortable clothing, that allow for freedom of movement (no jeans/restrictive fabric pants or short shorts).
- Any session cancellations due to inappropriate clothing will be charged for as per the late cancellation policy stated above
- Feel free to ask your practitioner any questions before, during, or after the session. Your practitioner is highly trained and will be happy to make you feel informed and comfortable.
- By clicking “I acknowledge” on the above statements, I hereby waive and release my practitioner and Restore Prehabilitation & Recovery from any and all liability, past, present and future relating to the services received