KX CONSENT FORM Complete Online Form Below Please Complete Consent Form Below First Name* Last Name* Email* Phone*Injury or area requesting massage*Consent to Assessments and or Massages provided by Active Movement Studio Physiotherapists* Yes I consent No I do not consent I consent to receive email discounts and promotional offers from Active Movement Studio. I understand that I can unsubscribe at any time.* Yes I consent No I do not consent
