Pre-Massage Health Questionnaire
Pre-Massage Health Questionnaire
Please complete this questionnaire prior to your first massage.
Submitting this form is a binding agreement that you acknowledge and agree that:
You are solely responsible for your own physical condition and for seeking medical treatment when necessary.
You acknowledge that the intent of the massage is not to diagnose or treat illnesses.
You certify that the contents of this intake questionnaire are true to the best of your knowledge.
You understand that either the you--the client--or the therapist can stop the massage session at any point during the session.
At any time during the massage if you are uncomfortable or feel severe pain please alert the therapist immediately.
You understand that all massages are provided subject to the Client Agreement and you agree to abide by those terms.