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MEDICAL HISTORY AND INTAKE FORM

By completing and submitting this form, I understand that any therapist working for South Paw Massage and Wellness is not a licensed veterinarian and does not diagnose, perform surgery, or prescribe medications. I declare I am the legal owner of the this dog and that all information presented is correct to the best of my knowledge. I give consent for my dog to be treated by South Paw Massage and Wellness. I also understand that muscle therapy and energy work is not a replacement for proper veterinary care. Any injuries or diseases must be medically diagnosed and treated by a veterinarian. I further understand that a complete history is necessary for accurate treatment of any kind and that participation by the owner/handler is essential to achieving beneficial results. Further, I understand that South Paw Massage and Wellness therapists are not responsible for any damages to others or to any property caused by my dog. I understand that payment is due in full at the time of treatment and that appointments not cancelled at least 24 hours in advance will be billed at half the standard fee.