New Clients Start Here…

Welcome to our massage therapy online booking center, where our appointment book is always available to you.

Since this is your first appointment please complete the client form below and then you will be routed to our scheduler where you can book your appointment with one of our massage therapists.

    Your Name (required)

    Your Email (required)

    Telephone (required)

    Has a physician or chiropractor recommended massage as a treatment for your pain?
    (required)

    Has your doctor ever advised against massage? (required)

    YesNo

    Is your pain due to a recent trauma? (required)

    YesNo

    Are you currently in pain? (required)

    YesNo

    Please describe briefly where your discomfort is

    Would you like special attention to any body parts during your massage?

    YesNo

    Which areas?

    List all medications you are currently taking

    List all surgeries

    List any conditions for which you have received medical treatment in the past 12 months

    Have you been in close contact with or cared for someone who you suspect has COVID 19 within the past 20 days? (required)

    YesNo

    Within the past 3 days have you had a fever? (required)

    YesNo

    Within the past 3 days have you had a sore throat? (required)

    YesNo

    Within the past 3 days have you experienced a new loss of taste or
    smell? (required)

    YesNo

    Within the past 3 days have you experienced a cough? (required)

    YesNo

    Within the past 3 days have you experienced shaking with chills? (required)

    YesNo

    Females Only:

    Are you pregnant or think that you may be pregnant?

    YesNo

    Acknowledgment and acceptance of disclaimer:

    -I understand and accept that massage therapy given here is for the purpose of, but not limited to: Fulfilling a prescription of a treating physician, for a medically necessary condition; for stress reduction, relief from muscular tension, or spasm; or for increasing circulation and energy flow.

    -I understand and accept that the Massage Therapist does not diagnose illness, disease, or any other physical or mental disorder. Massage therapy is not a substitute for medical examinations and/or diagnosis. It is recommended that I see a physician for any physical ailment that I might have. Because a Massage Therapist must be aware of existing physical conditions, I have stated all of my known medical conditions and take it upon myself to keep the Massage Therapist updated on my physical health.

    -I will respect the time of my Massage Therapist(s) and other clients. I agree to come to my scheduled appointments promptly, barring any unforeseen emergency. I understand that if I cancel later than 8 hours prior to my appointment, I will have to pay HALF the cost of my appointment. If I NO SHOW, I will have to pay the FULL price of the appointment.

    Agree

    Sign here: