Balanced Therapeutic Bodyworks

Intake Forms

The following forms are designed to help us work together more easily:

Client Intake Form

Please download this form and bring it to your scheduled session

Our Policies

This form outlines my polices for Cancellation, Late Arrivals and Inappropriate Behavior. MUST be signed by each client.

Covid Liability Release Form

This form is for all new patients releasing the practice of possible Covid exposure

Medical Release Authorization

Massage Therapists are bound by HIPPA. This form authorizes that any confidential information is private and restricted between the MT and Client.

General Liability Release Form

This form releases the Massage Therapist from general liability issues. Must be signed by each client.

Cupping Therapy Release

This form outlines any contraindications should you request Cupping Therapy performed for your session.

Hot Stone Massage Release Form

This form outlines the contraindications BEFORE Hot Stone Massage can be performed

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