Please print out the Customer Intake Form below and bring with you to your appointment.

 

 

Customer Intake Form
Customer Intake Form.pdf
Adobe Acrobat document [532.3 KB]

CANCELLATION POLICY : To avoid a cancellation fee, you are required to cancel an appointment at least 24 hours in advance by phone. This allows the opportunity for someone else to schedule an appointment. Failure to do so will result in a charge to your payment on file for the total service value. Anyone who either forgets or consciously chooses to forgo their appointment for whatever reason will be considered a "No-Show."  "No-Shows" will be charged the entire amount of the session to the payment on file.

 

INFORMED CONSENT : The above information is accurate to the best of my knowledge and I freely give my permission to be massaged. Massage is contraindicated for some serious medical conditions. It may be necessary to obtain a doctor's release or prescription before beginning therapy. I agree to inform the therapist of any experience of pain during the session. Also, it is my responsibility to keep my massage practitioner informed of any changes in my health and any medications that I may begin to take in the future. I understand that I will be properly draped at all times except the area being worked, and that the massage is not sexually oriented in any way. Any illicit or suggestive remarks or behavior on my part will result in immediate termination of the session with full payment expected. I give my consent to receive the treatment discussed in this and all future sessions. I agree that my presence at subsequent sessions shall be construed to be validation of this written consent. 48 Hour Notice of Cancellation is required. No Shows and Late Arrivals will be charged the amount of the full session and will not receive an extension of scheduled service time. If you are uncomfortable with ANYTHING at ANYTIME please inform your therapist.