Massage Intake Form | Sunrise Spa

*Areas of broken skin? (e.g., rash, wounds)

Yes

No

If yes, where?

Do you have any of the following? (check all that apply)

Please describe any injuries or health conditions:

*Reason for seeking massage:

Relaxation

Specific problem

Please list and describe any areas of discomfort:

By signing below, I acknowledge that I am aware of the benefits and risks of massage therapy and that I have completed this form to the best of my knowledge. I also agree to inform my massage therapist of any health or medical changes.

First Name

Last Name

*Signature

Submission Date

Sunrise Spa - Formerly Paradise Spa

Sunrise Spa
Massage Intake Form

If you are visiting first time, complete General Intake Form

If you prefer offline, download: Massage Intake Form PDF

Sunrise Spa - Formerly Paradise Spa

Sunrise Spa Massage Intake Form

If you are visiting first time, complete General Intake Form

If you prefer offline, download: Massage Intake Form PDF

Sunrise Spa
Massage Intake Form