Liability Release Form

Physical Capability Requirements

Participation in a NormaTec® Compression Therapy session involves exposure to vasopneumatic compression for a short period of time.  During the compression therapy session, a Bodyworks Massage DBA Woodway Wellness LLC employee will be present during the entire duration of your session.  Additionally, you are free to terminate the session at any time.

Contraindications

NormaTec® Compression Therapy is contraindicated for patients with: 

  • Current or unstable fractures/breaks      

  • Recent surgery and have sutures/stitches

  • Open wounds, contusions, abrasions

  • Suspect or known Acute deep vein thrombosis (DVT) (blood clot)

  • Severe atherosclerosis (disease of the arteries)/Ischemic vascular disease (IVD)

  • Severe congestive cardiac failure (CHF)

  • Existing pulmonary edema (having excess fluid in the lungs)

  • Existing pulmonary embolism (blood clot in the lungs)      

  • Extreme deformity of the limbs

  • Any local skin conditions such as gangrene, untreated or infected wounds, recent skin graft, or dermatitis

  • Known presence of malignancy in the legs or arms

  • Limb infections, including cellulitis that have not been treated

  • Presence of Lymphangiosarcoma (a rare cancer due to long-standing lymphedema of the upper/lower extremities)

Contraindications for LightStim Light Therapy
Although LED has no contraindications, if you are suffering from cancer, a terminal illness, or you are pregnant; we advise getting approval from your health care professional prior to light therapy treatment.  If you are on antibiotics or suspect you have skin sensitivity issues to light, please let us know and we will perform a skin sensitivity test. Extreme light sensitivity may cause migraines or activate seizure conditions. Other Precautions include: Use of photosensitizing drugs. History of Melasma. Clients who are pregnant must seek approval from physician. Clients with suspicious lesions or skin cancers should consult physician first. Accutane should be discontinued for six months prior to treatment.

I hereby affirm that I have responded to all questions honestly.  I acknowledge that LightStim and Bodyworks Massage DBA Woodway Wellness LLC service will rely on the information provided herein.  I agree to update any changes to the information provided herein prior to any future treatments.  I acknowledge and understand that LED light therapy treatment is not intended to diagnose, treat, cure, or prevent any disease or illness. 

I hereby voluntarily agree to release providing the service and LightStim, its owners and employees from any liability for any injury, loss or consequence that may arise as a result of or in connection to any LED treatments.

In consideration of being permitted by Bodyworks Massage DBA Woodway Wellness LLC to participate in their services for NormaTec® Compression Therapy and/or LightStim Light Therapy, I understand it may aggravate a pre-existing medical condition, or could lead to injury.  I am voluntarily assuming all risks of accident or injury to me (or my child) arising out of or in any way connected with the use of the services, equipment, or facilities of Bodyworks Massage DBA Woodway Wellness LLC.

I hereby release Bodyworks Massage DBA Woodway Wellness LLC and its staff members from all liability for any damage, injury, or harm, which may be caused by a result of, or in any way associated with participation in this service of Bodyworks Massage DBA Woodway Wellness LLC as a Guest.