We want to make your massage as beneficial as it will enjoyable.Take a moment to provide us this information.
Types of massage recieved before
Duration of workout
Do you have any issues such as these?
accident or injurysurgeryheadachesjoint issuesdisk problemsneck painback paindecreased range of motion
broken bonescarpal tunnel syndromesciaticanerve issuescrampssprains / strainsswellingbursitisarthritis
goutallergies (incl: oils/perfumes)varicose veins blood clot or phlebitisstrokeblood pressure issuesheart issuesskin disordersseizures
cancerdiabetesimplantssunburninflammation or infectionsfeverpainopen cuts, bruises, burnscontagious conditions
I understand that massage is a health aid and does not take the place of a physician’s care and no diagnosis will be made.If I am unable to make a scheduled appointment, I agree to cancel the appointment 24 hours in advance. If I miss a scheduled appointment without giving 24 notice, I agree to pay any missed appointment charge.I am responsible to pay for your massage fees at the time of service. I understand that my insurance company may cover massage and I will submit and manage this process myself.