Wild Wellness
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    Massage Therapy Consent Form

    I hereby request and consent to receive massage therapy and/or bodywork (specified below) from Marya DeLuna, CRMT, RMP of Wild Wellness, LLC (hereafter referred to as “the therapist” or “my therapist”).
    I confirm that I am over eighteen (18) years of age. 

    Payment:

    Cancellation Policy:

    By re-typing your name, you are adding your electronic signature to this form.
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  • Home
  • About
  • Services
  • Wild Wanderings
  • Classes & Workshops
    • Shop Classes
    • Class Intake Form
    • Class Waiver