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How did you hear about us?
Have you received a professional massage before?
What kind of pressure do you prefer?
Please check all conditions that apply, if checked, please elaborate:
Muscle / Joint Pain
High / Low Blood Preasure
Wear Contact Lenses
Jaw Clinching / Teeth Grinding
Numbness / Tingling
Accidents / Injuries / Surgeries (In the last 2 years)
Currently Taking Medications
I am aware that the massage therapist does not diagnose illness or disease, does not prescribe medications and that spinal manipulations are not part of massage therapy. I understand that massage therapy is not a substitute for medical treatment or medications and it is recommended that I concurrently work with my primary care doctor for any conditions that I may have.
I do not agree
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