Client Intake Form

Before coming in for your appointment, please download and complete the Client Intake Form below.  

• Please take a moment to read carefully, answer truthfully and sign where indicated. 
• If you have certain symptoms or if you have a specific medical condition, some types of bodywork may be contraindicated. 
• A referral from your primary care provider may be required prior to some services.

Please bring this form with you to your next appointment and be sure to contact us if you have further questions or concerns.