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I am aware that the massage therapist does not diagnose illness or disease, does not prescribe medications, and that spinal manipulations are not part of massage therapy.Client Intake Form Therapeutic Massage Personal Information: Name Date of Birth Address City/ST/Zip Phone (Day) Phone (Eve) Email OccupationMASSAGE CLIENT INTAKE AND RELEASE OF LIABILITY FORM Contagious Skin Condition Open Sores or Wounds Easy Bruising Recent Accident / Injury . from application of massage despite completion of this form. .Client Intake Form Therapeutic Massage .Massage Client Intake Form Massage Client Waiver Form Please take a moment to read and initial all of the following statements: If I experience pain or discomfort during the session, I will immediately inform my therapist so thatMASSAGE CLIENT INTAKE AND RELEASE OF LIABILITY FORM Contagious Skin Condition Open Sores or Wounds Easy Bruising Recent Accident / Injury Recent Fracture .19.Therapeutic Massage Client Intake Form The information request below assists us in treating you safely. Feel free to ask any question about the information being requested.Client Intake Form Therapeutic Massage Personal Information: Name Phone (Day) Phone (Eve) Address City/State/Zip email Date of Birth OccupationSeated Massage Client Intake Form Practioners Name: Date: Location: Clients Name: Address: City: State: Province: Country: Zip/Postal Code: Telephone: Fax: Email:Medical History In order to plan a massage session that is safe and effective, I need some general information about your medical history. 10.With this in mind, I agree to receive massage therapy and hold harmless SOMA Therapeutic Massage and the massage for any problems that might arise as a result of the massage session. Client Signature: Date: Parent or Guardian . Title: client intake form Created Date: 9/13/2017 2:49:42 PM .Save yourself some time by completing this Printable Client Intake Form before your first massage appointment. Please do not print this page. Print the pdf document from the link.Massage Client Intake Form Date: Name . Client Acknowledgment: I understand that therapeutic massage does not take the place of traditional medical care. It enhances health, creates a sense of balanced well-being, improving circulation, reflex points of the body, etc. Client .Massage Intake Form - CONFIDENTIAL INFORMATION WELCOME! I would like to make your appointment as pleasant and comfortable as possible. . Type of massage experienced (swedish, shiatsu, deep tissue, etc.) .Client Intake Form Therapeutic Massage Personal Information: Name Phone Date of BirthDocumenting Massage Therapy with CARE Notes W hen I was a massage student in 1984,we learned little about charting for massage therapy.We were required to write about a certain number of the . Client intake form An initial session with a client should begin with completion of an intake form.Depending on your set-ting,theseMedical History Do you currently have any of the following: (please check) phlebitis tennis elbow deep vein thrombosis/blood clots recent fractureClient Intake Form Daniela's Therapeutic Massage Download this form, f ill it out and bring it with you to your appointment.Raise your hand if you were using your massage school's sample intake form for the first several years of your massage practice! It's embarrassing to admit, but I did . A Sample Massage Therapy Intake Form (That You Can Actually Use) October 19, . Because you work hard enough, yo.Massage Therapy Initial Intake Form DATE Name . Massage Therapy is defined as the assessment and treatment of the soft tissue and joints of the body. Therefore, every Registered Massage Therapist .Client Intake Form Therapeutic Massage Personal Information: Name Date of Birth Address City/ST/Zip Phone (Day) Phone (Eve) Email OccupationMasseuses can prepare for massage sessions for individuals by learning about their background, former injuries, pain and goals with this printable massage therapy intake form.client intake form. client agreement It is my choice to receive massage therapy. I am aware of the benefits and . including intake forms, chart notes, reports, correspondence, billing statements, .Client Intake Form Therapeutic Massage Client intake form therapeutic massage Processing Using Matlab Physics 1210 Lab Manual Ohio State University Nt1210 Introduction Networking Lab 9 1210 Los AngelesMedical History Intake Form Sunrise City Spa Studio Personal Information Name email Phone (Cell) Phone (Home . License Massage Therapy reserves the right to refuse to perform massage on anyone whom he/she deems to .Client Intake Form Therapeutic Massage Client intake form therapeutic massage Processing Using Matlab Physics 1210 Lab Manual Ohio State University Nt1210 Introduction Networking Lab 9 1210 Los AngelesCome to In8 Massge to enjoy the type of massage best for you, whether it is a Swedish Massage, Deep Tissue Massage or a Therapeutic Massage. Prices for new clients first visit: 1 Hour Massage $49.00, 30 Minute Massage $25.00. New clients are required to fill out a two page health questionnaire.CARLISLE FAMILY YMCA 311 S. West St., Carlisle PA 17013 P 717 243 2525 ext 230 E jcattroncarlislefamilyymca.org W carlislefamilyymca.org THERAPEUTIC MASSAGE CLIENT INTAKE FORMSeated Massage Client Intake Form Practioners Name: Date: Location: Clients Name: Address: City: State: Province: Country: Zip/Postal Code: Telephone: Fax: Email: 87792ab48e
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