Consent for receiving treatments with a therapist from myblissfulretreat
I declare that the information I have provided is correct to the best of my knowledge and I understand that because my treatment may involve touch and close physical proximity over a period of time, there may be an elevated risk of disease transmission including covid-19.
I consent to the myblissfulretreat team and therapist retaining the details provided on this form for a period of 7 years from today. I further understand if I am under 18 years of age these records will be kept until I reach the age of 25 (7 years after reaching 18)
I give consent to receive treatments from the therapist assigned to my booking by myblissfulretreat
Please sign and date at the bottom of the form and submit your answers 48 hours before your booking in prder for your booking to go ahead.