Publication date:
27
June
2022
18
January
2024
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Minors' consent form

Body Stress Release (BSR) is a non-invasive therapy that uses gentle pressure techniques to release deep-seated muscle tension and stress.

  • Children up to 12 years: not legally competent; parents or guardians must consent to treatment and sign this form with the practitioner.
  • Minors aged 12 to 16: potentially competent; treatment generally requires the consent of both the minor and the parents/guardian and signs with the practitioner.
  • Minors aged 16 to 18: in principle, legally competent; this form does not need to be signed for treatment unless a minor is not legally competent.
  • If there are not one but two custody parents/guardians, this form must be signed by both parental parents/guardians and the practitioner. (The primary guardian is responsible for any lack of consent in case there is another guardian.)
  • Date: Location:
  • Parent (1) or guardian signature:


  • Parent signature (2):


  • Minor signature: 12 to 18 years

  • Practitioner signature:


  • Dates of release agreements:
  • 1st appointment: 2nd appointment:
  • 3rd appointment: Follow-up appointments:

Download Consent Form

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Would you also like to experience the benefits of BSR?

Click here for information on making an appointment.