Confidential Client Intake Form for Therapeutic Massage

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Important Note
All client files are kept strictly confidential. No information contained in these forms will be shared with anyone,
including other healthcare practitioners, without your signed consent.

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*** Massage should not be considered as a replacement for professional medical treatment: a physician should be consulted in all matters relating to health and especially in relation to any symptoms that may require diagnosis or medical attention. In some cases, a primary physician’s approval/prescription is required before any bodywork is administered. Care should be taken during pregnancy, particularly in the use of essential oils and pressure points. Essential oils should not be ingested, and should be used for babies and children only on professional advice.

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OR Business Registry #712758-96