Client Information


Medical Details


Areas Normally Massaged

These are the areas of your body that may be massaged. If you want our staff to avoid any areas, please remove the checkbox next to the named area.



Lifestyle Information


Client Agreement

I understand if I experience any pain or discomfort during my session(s), I will immediately inform the therapist so the pressure and/or strokes may be adjusted to my level of comfort. I further understand massage/bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment I am aware of. I understand massage therapists are not qualified to perform skeletal adjustments, diagnose, prescribe, nor treat any physical or mental illness, and nothing said in the course of the session(s) given should be construed as such. Because massage/bodywork should not be done under certain medical conditions, I affirm I have stated all my known medical conditions and have answered all questions honestly. I agree to keep the practicioner's updated as to any changes in my medical profile, and I understand there shall be no liability on the practicioner's part should I forget to do so. It is also understood any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment for the full scheduled appointment.