Please fill out the COVID Questionnaire prior to scheduling your appointment. Then fill out this secure Health History form prior to arriving for your appointment. Thank you!

Client Information & Health History

All information, including contact information is confidential

  • Food and Exercise Per Day:

  • Cancellation Policy: Appointments must be cancelled 48 hours prior to your scheduled appointment or you will be charged 50% of the rate for first offense. Full amount will then be charged for future offenses.

    *** It is recommended that you get a medical doctor's opinion if you have a painful condition. The information provided by your massage therapist or bodyworker is for educational purposes and is not diagnostically prescriptive in nature.

    ++ I agree to participate as much as possible in my own healing.

  • Date Format: MM slash DD slash YYYY


Skilled Neuromuscular and Craniosacral Therapy treatment can more easily and efficiently release the habituated patterns and provide relief.