Terms and Conditions

CLIENT LIABILITY WAIVER & INFORMED CONSENT

A. Nature of Services

I understand that massage therapy and LED/near-infrared light therapy are for general wellness and relaxation. No medical care is being provided.

B. Medical Disclosure

I agree to disclose my complete health history and notify the therapist of any changes before treatment.

C. Assumption of Risk

I voluntarily accept all inherent and possible risks. I understand reactions such as temporary soreness or skin sensitivity may occur.

D. Illness & Hygiene

If I am ill or contagious, I agree to cancel and will not be penalized. The therapist may stop or refuse services if illness or safety concerns arise.

E. Boundaries & Consent

I understand:

• Professional draping is required
  
  

• Any sexual, disrespectful, or inappropriate behavior is grounds for immediate termination
  
  

• Genitals must remain covered and not contact equipment
  
  

• Damage or contamination to equipment may incur replacement costs
  
  

If dismissed for behavior, I will not receive a refund and may be permanently banned.

F. Minors (if applicable)

Any session involving a minor is supervised according to business policy.

G. Liability Release

To the fullest extent allowed by law, I release and hold harmless Marlene J Goodman, LMP, LLC from all liability for injuries or damages other than those directly caused by intentional misconduct or gross negligence.

H. Device Damage Responsibility 

Clients are expected to use all equipment and devices safely, appropriately, and only as instructed. Any damage or contamination to the equipment, treatment tables, light therapy devices (including but not limited to Celluma and Mito devices), or any other property belonging to Marlene J Goodman, LMP, LLC that occurs due to client action, negligence, misuse, or violation of clinic policies will result in the client being fully responsible for the associated repair, cleaning, or replacement costs. The determination of cause and the amount owed will be made at the sole discretion of Marlene J Goodman, LMP, LLC.

If contamination or damage occurs due to contact with any private areas, bodily fluids, oils, or unsafe placement of the body, cleaning and/or replacement fees will be charged accordingly. Severe misuse or intentional misconduct may also result in immediate termination of the session and permanent banning from the practice without refund.

I.  Insurance and PIP Billing

Bellevue Light Therapy & Massage (Marlene J Goodman, LMP, LLC) provides billing services only for Personal Injury Protection (PIP) claims. Submission of PIP claims is provided as a courtesy and does not guarantee payment, coverage, or approval by the insurer.

For all other insurance types, Marlene J Goodman, LMP, LLC does not bill insurance directly. Upon request, clients may receive a detailed receipt or “superbill” to submit to their insurer for potential reimbursement.

Clients acknowledge that they remain fully responsible for all charges related to services rendered, regardless of the outcome of any insurance or PIP claim. If an insurer denies, delays, or partially pays a claim, the remaining balance is the client’s responsibility and is due within fourteen (14) days of notice.

Clients are encouraged to verify their insurance coverage, claim submission requirements, and reimbursement policies directly with their insurer prior to treatment.

I. Payment Policy

Deposits, late cancellation, and no-show rules have been explained to me. I agree to the fee structure.

J. Agreement

I have read and understand this agreement and have had the opportunity to ask questions.