407 443-1550 Multi-Modality Approach To Pain Relief
407 443-1550Multi-Modality ApproachTo Pain Relief
Health Intake Form
HIF 2017.doc
Microsoft Word document [43.0 KB]

If you are a new client, please download and complete the health intake form, if possible, and have it ready before your 1st massage.


We consult with all our clients first to make sure they are healthy to receive massage. 


This time also allows you to point out specific areas of discomfort, establish mutual understanding and ensure your expectations are met.



Why is the health history important?


The health history form is important because it gives an overview of a client’s health so the therapist can proactively determine the correct treatment, or even if the client should receive massage. Please remember that what you say to your massage therapist is confidential, and files are stored in a secure place. Your massage therapist will not discuss your medical issues with anyone unless you have signed a consent form giving your therapist permission to do so. 


Massage is not recommended for everyone, the following are some of the conditions:

  • Infectious skin disease, rash, open wounds
  • Immediately after surgery, chemotherapy, radiation unless doctor recommended
  • Those with blood clots
  • Tumor, inflamed skin, unhealed wounds
  • High fever, pitted edema
  • Acute inflammation, kidney disease
  • Women in their 1st trimester
  • Heart disease - get ok from your doctor

Also, no food, RX or alcohol 2 hours before your treatment.