Client Intake Form

The following Confidential Client Intake Form is designed to help us work together more effectively. Certain medical conditions and medications can cause contraindications for massage. For example, if a client were to take certain pain medications or muscle relaxants, it could dull his or her perception of pain and pressure during a massage which could possibly cause injury to the client; especially during a deep tissue massage.  

To look out for the best interest of my business, and to ensure I provide safe and therapeutic massage therapy services, the Confidential Client Intake Form must be filled out completely and/or reviewed prior to the beginning of each massage therapy session. Help me, help you!  

Thanks in advance for your cooperation!

Confidential Client Intake Form

If you are a first-time client, please print out the form, fill it out completely, and bring it with you to our first appointment.

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