Your comfort comes first.

1. Your details

Complete every field. Enter “None” where appropriate, or “Discuss privately” for details you prefer to share in person. Your therapist must review relevant concerns before treatment.

2. Health & preferences

Include conditions that may affect massage, such as circulation or heart concerns, blood clots, diabetes, reduced sensation, fragile bones, cancer treatment, skin conditions or infection.

Describe pain, swelling, fever, feeling unwell, or what you hope to address.

Include medicines relevant to treatment, such as blood thinners, pain medicines or medicines affecting skin or sensation.

Include location, timing, restrictions and any advice from your healthcare professional.

State whether you are pregnant, may be pregnant, or recently gave birth, and any relevant restrictions. You may write Not applicable or Discuss privately.

Include oils, fragrances, lotions, latex or other products.

List areas you do not want touched or want to discuss before treatment.

Include positioning, draping, heat, products, conversation or techniques you wish to decline.

3. Consent & signature

Your intake and signature will be available only through the protected therapist review workflow. Please do not share your private booking link. This form does not provide medical advice or emergency care.