GOR 6/2/24

Consent to Treatment

Fluid Physio is a hands-on Physical Therapy clinic. Thorough and highly specialized treatment consists primarily of manual therapy techniques and treatment forms that are published or otherwise publicly known. Forms of ultrasound, electrical stimulation, traction, deep tissue massage, therapeutic exercise programs, gait training, neuromuscular reeducation, myofascial release, bone, and soft tissue manipulation, as well as other treatment modalities, may be used. Internal pelvic exams may be performed if symptoms and patient goals warrant it, and patient may defer or object to this at any given time. Some of the hands on treatment techniques require deep pressure which may cause bruising and periods of increased soreness which may last 1-72 hours. Symptoms may also change and move to other parts of the body. This is not unusual and is rarely a concern, however, please ask if you have any concerns or questions. The number of treatments needed, and recovery time can vary due to the age of injury, number of times injured, age of patient and many other contributing factors.

I have read and fully understand the above statements. I understand the nature of the treatments at Fluid Physio, LLC. I authorize Gianna Bigliani Cetkowski, PT, DPT, OCS, CSCS and the fully trained staff to use treatment techniques as deemed necessary for my safe and effective recovery.

By filling out the RSVP form you are consenting to treatment.