Start your visit stress-free.
Fill out your new-patient paperwork before you arrive and we'll be ready for you the moment you walk in.
New Patient Intake Form
Our two-page intake form covers your contact details, medical history, and consent for treatment. Please print, complete, and bring it with you — or fill it out in our waiting room if you prefer.
What's Included
Two pages, a few minutes of your time
Page One — Your Information
Basic contact and background details so we can prepare for your visit and reach you if needed.
- Contact & emergency details — name, address, phone, emergency contact.
- Referring physician — name and phone, if applicable.
- Current medications & allergies.
- Reason for visit and prior massage experience.
Page Two — Health History & Consent
A brief medical history checklist and an informed-consent statement covering the benefits and risks of massage therapy.
- Medical history checklist covering major body systems.
- Informed consent for treatment and confidentiality.
- Insurance responsibility acknowledgment.
- Signature & date to complete your file.
All Set?