Client History Form – Pregnancy Massage

Home / Client History Form – Pregnancy Massage

Dear client,

Please take a moment and carefully read the following questions. Your answers will be discussed with you prior to your session. We want to make sure that we understand your specific needs, so we can create the best treatment for you possible. Thank you for your time.

I have completed the massage intake form and all information is true and correct. I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the therapist so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage should not be construed as a substitute for medical examination, diagnosis, or treatment, and that I should see a physician or other qualified medical specialist for any mental or physical ailment that I am aware of. Because massage should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly.