Screening Questionnaire

Screening Questionnaire

In order to ensure that you’re getting the highest quality service possible, please print and return this questionnaire. Not only to give me additional information about you, but to make sure that you’ve received important information from us....
Physician Referral

Physician Referral

If you were referred to us by a health care professional, please print out and provide us with their information.    
Health Care Providers Permission

Health Care Providers Permission

Please provide your Physician or Health Care Providers permission to use massage and/or bodywork with you. Include any restrictions or consideration before beginning treatment.
Health Status Update

Health Status Update

Depict how you are feeling today by printing out our health status update form, and drawing a circle on the figures representing the size and shape of the listed symptoms. Use P for pain, ache, or tenderness, and S for stiffness in the joint or muscle.  
Client Information

Client Information

In order to best serve your needs, we’d like you to answer some simple health questions for us, including current or past medical conditions. These forms include a Consent for Treatment, stating that we’re able to perform massage/bodywork services, not...
Client Feedback Form

Client Feedback Form

My goal is to provide clients with the best possible massage experience. I appreciate your willingness to take the time to give me honest feedback! Please print out our feedback form, and rate each question on a scale from 1-5 (where 1 is poor, and 5 is excellent)....
Body Map

Body Map

Please take a few moments to download our body map, and mark your trouble areas. Using T for tension and hypertonicity, P for pain, S for spasm, I for inflammation, and N for numbness and tingling. This will better help me understand what areas of your body need...
The Benefits of Massage

The Benefits of Massage

Experts estimate that upwards of ninety percent of disease is stress-related. And perhaps nothing ages us faster, internally and externally, than high stress. Massage is an effective tool for managing this stress, which translates into: Decreased anxiety Lower Blood...