Patient Intake Forms
Prior to receiving your first massage treatment, please complete the Patient Intake Form below and bring it with you to your appointment. You may also complete the form and email it in advance of your appointment to [email protected].
In addition to the Patient Intake form, if you will be receiving therapeutic breast massage treatment, please also complete the Informed Consent for Breast Massage Form below, and bring it with you or email prior to your appointment.
The information requested on these forms will provide insight to your health history and wellness condition, which will enable you to receive the best treatment applicable to your current health needs. Thank you for your cooperation.
In addition to the Patient Intake form, if you will be receiving therapeutic breast massage treatment, please also complete the Informed Consent for Breast Massage Form below, and bring it with you or email prior to your appointment.
The information requested on these forms will provide insight to your health history and wellness condition, which will enable you to receive the best treatment applicable to your current health needs. Thank you for your cooperation.
pure_life_massage_therapy_informed_consent_for_breast_massage.docx | |
File Size: | 129 kb |
File Type: | docx |
pure_life_massage_therapy_patient_intake_form.doc | |
File Size: | 140 kb |
File Type: | doc |