Massage Inquiry Form

Have you had a professional massage before?

Yes No

Duration

60 minutes 90 minutes 120 minutes

What pressure do you prefer

Light Medium Hard

"Which areas would you like us to focus on during your massage? (Select all that apply)"

Are there any areas (feet, face, abdomen, etc.) you do not want massaged?

(For Female) Are you currently pregnant?

Yes No

Please indicate any of the following that apply to you

Are you taking any medications? If yes please specify

Do you have any allergies or sensitivities?

Yes No

By signing this consent form, you acknowledge and agree to the following:

I understand that massage involves physical touch and stretching techniques to promote relaxation and well-being.
I confirm that I have disclosed all relevant medical conditions, injuries, or allergies to the massage therapist.
I understand that massage is not a substitute for medical treatment and that no specific health outcomes are guaranteed.
I consent to receive massage services and agree to notify the therapist if I experience any discomfort during the session.
I am participating voluntarily and assume full responsibility for any risks associated with the massage.

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