I understand that by submitting this form I am consenting to receive a reflexology treatment. I understand the implications of receiving a treatment and that this reflexology session is not a substitute for medical treatment. The information I have declared in this form is correct to the best of my knowledge and I agree to keep the service provider updated with any changes in my health prior to any future sessions and understand that there shall be no liability on the therapist's part nor on the part of the business should I fail to do so. I agree for the business to use and safely store the data submitted on this form.