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Intake Form

Personal Information

Massage Information

Do you want stretches included in your massages?
What Activities Therapies Have You Found Helpful for Your Lifestyle?
What Activities Therapies Have You Found Helpful for Your Lifestyle?
What results do you want from your treatments?
Are you sensitive to Scents? Do you have any allergies?
Are you sensitive to Scents? Do you have any allergies?
Your music preference
Areas of Your Body that You Hold Tension or Stress
Areas of Your Body that You Hold Tension or Stress
Which area or areas do you not preferred worked on?
Which area or areas do you not preferred worked on?
Where did you hear about us from?
Where did you hear about us from?
I understand...