Health & Consent Form

Hi! Thanks for booking with me again 🙂

Here is a (shorter) Form for you.

We want to include updates on your body since the previous appointment, on how you are feeling physically and emotionally, your needs and Intentions for this particular session.

(Things you want more of and things you want less of)

Name *

Email *

How are you feeling at the moment?

Excellent
Good
Fair
Poorly

Activities and frequencies / Have you been stretching-foam rolling?

what are your Goals for this session? *

What kind of touch/ pressure will you prefer this time *

Massage Length

Anything else you would like to share with me?

I have completed this form to the best of my knowledge and will inform the massage therapist of any change in my physical health.

I agree

I understand that the massage I receive is provided for the basic purpose of relaxation, stress reduction and relief of muscular tension. If I experience any discomfort, I will inform the practitioner so that the pressure may be adjusted to my level of comfort. I_understand that all information that I provide will be kept confidential. I am aware of the benefits and risks and give my consent for massage.

I agree

I agree

Signature

Comment

Health & Consent Form

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