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Client Intake Form

Preferred Method of Conact
Have you ever received professioal massage/bodywork before?
Massage Style Preference
What kind of pressure do you prefer?
Do these symptoms interfere with your activities of daily living (e.g. sleep, exercise, work, childcare)?
Select any of the following health conditions that you currently have. If you are unsure, please ask. Please answer honestly, as massage may not be indicated for these conditions:

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