Prenatal Consent Form

Name
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Massage therapy during pregnancy has been shown to be beneficial for several common complaints such as fatigue, musculoskeletal pain, sciatica, and edema. However, there are risks associated with specific conditions that may occur during pregnancy. Below is a list of many symptoms or complications that can occur during pregnancy and may require the therapist to alter or cancel your session. You must also inform your massage therapist if you have or had any of the following conditions. Please check off any that may apply to your current or past pregnancies:
Choose all that apply