Client Intake / Health History Form - If you are a first time client, or if you have not been in within the past six months, please print this form, complete it, and bring it along to your first session.
Minor Informed Consent Form - The benefits of therapeutic and orthopedic massage have no age limit, however minors (children under the age of 18), must be accompanied by or have the consent of a parent or guardian via this written minor informed consent form.
Prescription for Massage - This form is required if you are wanting to do Medical Massage. You always need a prescription for medical massage, even if your plan says that you can self-refer. Medical Massage is result oriented and the treatment is specifically directed to resolve conditions that have been diagnosed and prescribed by a Physician. The therapist may use a variety of modalities or procedures during the treatment, but will focus the Medical Massage treatment only on the areas of the body related to the diagnosis and prescription. We will always need a prescription from your doctor before commencing medical massage treatments. You will also need this form if you are currently under the care of a physician for an illness or acute/chronic injury, regardless if you are coming in for Medical Massage.
540 Bryant Street, Palo Alto, California 94301 | (650) 815-6552
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