Intake Forms

(For Pregnancy Massage, Minor Massage and Cupping Massage therapy please scroll down and print additional forms to fill out)

General Intake form:

Please print and fill out this simple 1 page Intake form below to help me tailor your therapeutic session and bring to your appointment for a speedy check in!



Only fill this Intake form below for your minor patient when bringing your child to the appointment:

Minor Consent




Please print and fill out this additional form below if you are pregnant:

pregnancy release