Date of birth
Have you ever received massage therapy
What type of Touch do you prefer?
How many hours per week do you participate in activities or sports?
What are your goals for massage?
Please list any allergies
Please check any area you do NOT want massaged.
Are you pregnant?
Please list any health conditions/recent surgeries.
I understand that appointment cancellations require 24 hour notice. Cancellations without proper notice can be charged the full session fee.
I understand that massage is not a replacement for medical care and that no diagnosis will be made.
I understand that the services offered are Non-Sexual and if such speech or actions occurs, the therapist will end the session immediately.
I understand that after 15 minutes that appointment will be considered a NO Show. Time is NOT made up if client is late. If I start late, the client will receive their full time.
Please list any other concerns/details for this session.