Intake Form
Are you taking any medications?*
Are you currently pregnant?*
Do you suffer from chronic pain?*
Have you had any orthopedic injuries?*
Select which ones apply to you
Explain any conditions marked above
Have you had a professional massage before?*
What type of massage are you seeking?
What type of pressure do you prefer?
Do you have any allergies or sensitivities?*
Are any areas you do not want massaged?*
What are your goals for this treatment?
Select any areas of discomfort