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Discover Tranquility in Your Own Space

we bring the spa to you

thank you for scheduling

Please take a few moments to complete the client intake form so that we can be prepared for your session. 

This form must be completed 24 hours in advance of your session.

Birthday
Month
Day
Year
Multi-line address
Emergency Contact Relation
Do you have any of the following conditions? Check all that apply
Have you recently been or are you pregnant or nursing?
Are you currently experiencing and of the following symptoms?
What is your primary goal for your session?
Do you have an area of your body that needs special attention?
What type of pressure do you prefer during your massage
How would you rate your stress level
How often do you exercise?

Consent & Acknowledgement

 I consent to receiving massage therapy and understand that the therapist will respect my boundaries throughout the session and commit to respecting theirs.


I acknowledge that all information provided is accurate to the best of my knowledge and that it is my responsibility to inform my therapist of any changes in my health status.

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