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These are the only required fields, but we encourage you to be as thorough as possible throughout the form.
*You must be at least 18 years of age to receive massage therapy and reiki services.
By clicking the “Submit” button, I acknowledge that if I have a medical condition, I have been cleared for massage by my physician. I understand that massage therapists do not diagnose illness or any physical or mental disorder nor do they prescribe any medical treatment. Massage therapy is for the well being of the body and mind. I understand that my health information will only be utilized by my therapist and everything we discuss will be kept confidential. To better the results of my massage, I have fully completed the above information to the best of my knowledge.
I also understand that massage therapy is not intended for sexual purposes. At any time during the massage should I or the therapist feel uncomfortable, the session will be terminated.