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I, , hereby acknowledge that I have requested that my massage include the use of cannabidiol (CBD)-infused creams, salves, or oils and I consent to the use of such CBD topicals in any massage I receive from . This acknowledgment and consent is effective until revoked, or for one year from the date of my signature, whichever occurs first. While no research has been conducted that indicates any risk for pregnant or lactating women using CBD, I affirm that I am not pregnant or nursing at this time. Date Signature WRITTEN CONSENT FOR USE OF CBD-INFUSED TOPICALS

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