Therapeutic Relationship Policies
Therapist/Client Agreement

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It is important that Integrative Orthopedic Massage, LLC and my clients both have a clear and mutual understanding of the therapist/client 
therapeutic relationship policies in this agreement. Please take a moment to read these agreements and contact me if you have any questions.

 

Cancellation/No Show

When you book an appointment, an APPOINTMENT DETAIL email/text is sent immediately. I encourage you to mark your appointments in your calendar so you are aware of them ahead of the automatic reminders.

72 hours before your appointment, a CONFIRMATION REQUEST is sent asking you to confirm your appointment to let me know you'll be there.

48 hours before your appointment is the cut-off window for cancelling/rescheduling without being charged a late cancellation fee.

24 hours before your appointment, a REMINDER is sent by the same delivery method to ensure you're prepared for your appointment and show up on time.

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***DO NOT RESPOND TO AUTOMATED MESSAGE REMINDERS, THEY WILL NOT COME TO ME***

***CALL OR TEXT 262-343-2525 FOR QUICKEST RESPONSE***

***If you are not receiving these notifications, please let me know ASAP so I can make sure your contact information and profile settings are correct in the system.*** This system should eliminate any late arrivals, late cancellations, and no-shows unless an emergency arises.

 

If you need to cancel or reschedule your reserved appointment a 48-hour notice is REQUIRED to avoid a 50% late cancellation charge for your reservation. You must cancel or reschedule your appointment either online or by leaving me a voicemail and/or text at 262-343-2525 at least 48 hours in advance. Note that I have not received your cancellation notice until I respond and confirm that I have received it. An appointment is considered a NO SHOW if I have been given NO PRIOR notice of a cancellation prior to the start time of the scheduled appointment.  "No Show" will be charged the full scheduled session fee. 

 

Any late cancellation or no-show fees are payable at time of service or will be charged to your account:​

• Charging your account will put your account in a deficit, which will be invoiced to you. All invoices are payable in 5 days via cash, check or credit card. Venmo and Apple Cash are also accepted. Accounts with outstanding balances will not be allowed to book until paid in full.

• Accounts must be at zero balance to get an approved scheduled appointment.

• This policy also applies to pre-paid appointments.

• Invoices unpaid past 30 days will be considered a terminated client and will be unable to book further appointments. In the event that a financial hardship is preventing an up-to-date credit on your account, please contact me directly to discuss further options.

• If booked under a gift certificate a no-show will redeem the gift certificate. If credit on certificate isn't enough to cover the missed appointment, an invoice will be sent for the remaining balance of the missed appointment.

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Two (2) late cancellations on your account will require a 3 month waiting period to rebook after assessed late fees are paid in full AND a pre-paid, non-refundable cash deposit of 50% for each future booking.

Two (2) missed appointments on your account will require a 6 month waiting period to rebook after assessed no show fees are paid in full AND a pre-paid, non-refundable cash deposit of 100% for each future booking.

 

This policy will remain in effect until account is in good standing and clear of any charges for one full "active" calendar year, meaning you remain a regular active client as scheduled. All cash deposits are non-refundable and will be applied towards the next scheduled appointment.

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Late Arrivals

Out of courtesy for my schedule and the clients scheduled before and after you, please make sure you arrive on time. If you arrive late for your appointment, the remaining time will be used and you will be charged the full amount of the session. Discounts will not be given for late arrivals, and time extensions will not be allowed.

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Vaccines / Shots / Injections

• Minimum of 5 days to get massage after receiving a COVID-19 vaccine (1st and 2nd shots and all boosters)

• 72 hours (3 days) to get massage after receiving the Shingles vaccine (1st and 2nd shots)

• 48 hours (2 days) to get massage after receiving the flu shot

• Please DO NOT come to a massage immediately after having a blood draw.

• For recent Cortisone shots, please contact me to discuss.

• For recent Botox injections, please contact me to discuss.

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Illness/Sickness

For the safety and well-being of you, my other clients, and myself, if you are feeling ill, please reschedule your appointment. If you arrive knowingly feeling ill or have any contagious conditions, I reserve the right to cancel/reschedule your appointment and charge 50% of the session fee and will be marked and treated as a late cancellation. These conditions can include, but are not limited to fever, vomiting, common cold, respiratory infection, chicken pox, shingles, influenza, ringworm, etc. It is not recommended to receive massage if you are under the influence of alcohol, this includes a hangover, as massage can exaggerate symptoms and create illness. 

 

For the same reasons listed above, for the safety of my clients I will contact you to reschedule if I'm ill. 

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Medical Procedures

If you have recently had a medical procedure, please contact me to discuss any precautions we need to take and to update your health information for your upcoming massage appointment. If you arrive to your appointment and I am not notified in advance of recent medical procedures that contraindicate massage resulting in me turning the appointment away, there will be a charge assessed of 50% of the service payable at the time of the appointment and the appointment will be marked and treated as a late cancellation. Such medical procedures may include but are not limited to eye surgery, hernia surgery, skin procedures, before recovery time without approval, etc.

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Medical History and Health Disclosure

For the safety of my clients, I must review your health history prior to all massage treatments. It is imperative that you report all medical related health conditions to me, and provide updates as any new conditions arise. Certain health related concerns may "contraindicate" some or all massage modalities. Contraindicate means that massage is not recommended, either locally or for the whole body, therefore precautions must be taken. I have the right to refuse service if I believe that massage could harm you due to any contraindicated medical condition or suspected health problems, even with a doctors approval. If you have any concerns about a health related issue, it is best to consult your physician prior to receiving any massage therapy treatment. If you wish for me to consult with your physician or other health related professional, please fill out the Authorization to Release Medical Records form and return it to me at your earliest convenience.

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If you are unsure if massage is appropriate for any reason (sunburn, recent medical procedure, experiencing an allergic reaction, etc.) please call or text me at least 48 hours before your appointment to discuss your symptoms so that I can determine whether it is safe to follow through with the treatment. If you show up to your appointment with a questionable condition and I deny the appointment, there will be a late cancellation fee accessed of 50% of the service booked, which will be payable at the time of the appointment, and the appointment will be marked and treated as a late cancellation.

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Appointments

Massages are by appointment only. I do not take same day appointments unless it's an emergency and if scheduling allows. Available days and times are listed under the Book a Massage tab of this website. To ensure appointment availability, I recommend pre-scheduling a regular series of appointments. Currently I have booking open 3 months in advance.

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Payments

Prices are listed in the Book a Massage or Bookings/Rates section of this website. Online appointments require a credit card at the time of booking. Payments for appointments booked in-house are due at time of service. Cash, credit cards, and FSA/HSA cards are accepted. Receipts are available upon request. To redeem a gift certificate, please specify when scheduling your appointment in the notes section. Prices are subject to change at any time and without notice.

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Refunds

No refunds. All sales on services rendered are final. All sales on gift certificates are final. 

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Inclement Weather

Unfortunately, we live in an area where the weather can be unpredictable and in the winter months traveling can be dangerous. Cancellations due to severe weather WARNINGS will NOT be charged a fee for a late cancellation.

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Gift Certificates

• Please create a note with the gift certificate number at time of scheduling.

• Gift Certificate must be presented at time of appointment.

• A gift certificate is considered "redeemed" (used) if a client does not show up for their scheduled, confirmed appointment.

• All policies apply to Gift Certificates including late cancellation fees.

• The paid value of a Gift Certificate has no expiration date. 

• HSA/FSA cards may NOT be used to purchase Gift Certificates.

• We do not accept competitors coupons or gift cards.

• We do not price match.

• All Gift Certificate sales are final. No refunds.

 

Charitable Donations

Each year I donate a set amount of Gift Certificates to local charities. If you are looking for donations for your charity,

please contact me at 262-343-2525 to apply for a Gift Certificate donation. 

• The expiration date on charitable donations are firm.

• All policies and procedures stated here apply to all charitable donation Gift Certificates.   ​

• Limit 1 per charity, as available. 

• No cash value.

 

Flex Spend Account (FSA) / Health Savings Account (HSA)

I DO accept payments from flex spending and health savings accounts in the form of credit/debit cards. Please advise us prior to your appointment so we can provide the correct documentation with your payment at the time of service. It is your responsibility to know and understand the terms of your account and to provide all required documentation when using FSA/HSA cards. FSA/HSA cards may NOT be used to purchase gift certificates.

 

Insurance Reimbursement

We DO NOT bill health insurance plans. Some insurance companies may offer reimbursement for certain massage treatments. Please contact your insurance company PRIOR to your massage sessions to see if you're authorized to submit a request for reimbursement. You are responsible for payment at time of service. We will submit receipts upon request. It is your responsibility to obtain the documentation (doctor prescription, letters of medical necessity, etc.) that may be required by your insurance company. 

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Request For Medical Records

Your records request MUST be submitted in writing to:

Integrative Orthopedic Massage, LLC

336 North Ave.

Kewaskum, WI 53040

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Informed Consent / Consent to Treat a Minor

On your first visit you will receive a copy of the massage therapy informed consent form and will be asked to sign the consent stating that you have read the information, understand it, and agree to comply with the professional massage therapy policies and procedures. Minors must have a parent in the treatment room during their entire session, and Consent to Treatment of a Minor MUST be given prior to any treatment. Save time by printing and filling out the Massage Therapy Health Questionnaire form (which contains the written consent) prior to your appointment. Certain health conditions may be contraindicated for massage therapy. See Medical History and Health Disclosure for explanation.

 

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Rev. 08/12/2023

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