I hereby consent to receive physiotherapy treatment.

I understand that physiotherapy treatment may involve, but is not limited to, the following:

• Manual therapy techniques
• Therapeutic exercises
• Education on injury prevention and rehabilitation
• Home exercise programs

I acknowledge that the physiotherapist has explained the nature, purpose, risks, benefits, and alternatives of the proposed treatment to me in a language that I understand. I have had the opportunity to ask questions, and all of my questions have been answered satisfactorily.

I understand that there are risks associated with physiotherapy treatment, including but not limited to:

• Temporary soreness or discomfort
• Bruising or swelling
• Aggravation of existing symptoms

I understand that the physiotherapist will make every effort to minimize these risks and ensure my safety during treatment.

I consent to the physiotherapist's assessment and treatment plan, which may be adjusted based on my progress and response to treatment.

I understand that I have the right to withdraw my consent at any time and to refuse any part of the proposed treatment plan.

I understand that it is my responsibility to inform the physiotherapist of any changes in my condition or any new symptoms that may arise during the course of treatment.

I acknowledge that a cancellation fee will be charged if I cancel my appointment less than 24 hours before the scheduled time, except in cases of emergency or unavoidable circumstances.