Wellness Intake Form-0

Wellness Intake Form

We want to make sure your treatment is as comfortable and effective as possible.

Please take a moment to complete this wellness intake form before your appointment. Your responses help our practitioners provide the safest, most personalized experience for you.

Full Name
Email Address
Phone Number
What service are you coming in for?
Do you have any health conditions we should be aware of? (e.g. heart conditions, pregnancy, recent surgeries, cancer)
Pressure preference (for massage)
Are there any areas of the body you'd like us to focus on?
Are there any areas of the body you'd like us to avoid?
Do you have any skin sensitivities, allergies to oils, or skin conditions we should know about?
I consent to receive the requested wellness treatment and confirm the above information is accurate.
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