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Cupping Therapy Release Form Amethyst Road LLC Dorothy Pigue 32 Johnson Drive Braselton GA 30517 I understand that all treatments at this facility are therapeutic in nature. I agree to communicate to the therapist any physical discomfort or draping issues during the session. Information has been provided to me about Cupping Therapy. It has been explained to me that there are contraindications for Cupping Therapy. I have fully disclosed all health factors to my therapist including those not...
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How to fill out the cupping therapy release form:

01
Start by filling in your personal information such as your name, address, phone number, and email address.
02
Next, provide details about your medical history including any existing conditions, medications you are currently taking, and any allergies you may have.
03
It is important to answer any questions related to your previous experiences with cupping therapy. If you have never undergone cupping therapy before, indicate so on the form.
04
Review and sign the consent section of the form, acknowledging that you have understood the risks and benefits of cupping therapy.
05
If applicable, provide emergency contact information.
06
Finally, date and submit the form to the cupping therapist or clinic.

Who needs a cupping therapy release form?

01
Individuals who are considering undergoing cupping therapy treatment.
02
Those who have previously experienced cupping therapy and are seeking additional sessions.
03
People who are required to fill out the release form as part of the policies and procedures of the cupping therapy clinic or practitioner.
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The cupping therapy release form is a document used to inform patients about the risks and benefits of cupping therapy and to obtain their consent to undergo the treatment.
Patients who wish to receive cupping therapy are required to fill out and sign the cupping therapy release form.
To fill out the cupping therapy release form, patients should provide personal information, read through the risks and benefits, and sign the form indicating their consent.
The purpose of the cupping therapy release form is to ensure that patients are fully informed about the therapy and to protect the practitioner legally.
The cupping therapy release form should report information such as the patient's medical history, potential contraindications, acknowledgment of risks, and the patient's consent.
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