Intake form

Name *

Email address *

What type of massage are you interested in?

Please select at least one option.

Swedish Massage

Deep Tissue Massage

Sports Massage

Trigger Point Therapy

Hot Stone Massage

What are your primary goals for your massage session?

Please select at least one option.

Pain Relief

Stress Reduction

Relaxation

Improved Mobility

Overall Wellness

Do you have any specific areas of tension or pain?

Have you received massage therapy before?

Do you have any medical conditions or injuries we should be aware of?

What is your preferred appointment date and time?

Additional questions or comments

Lane O. II Therapeutic Massage