• Touch Education, LLC Confidential Intake Form

    Matthew Howe ~ Nicole Howe
  • This form must be completely filled out, signed, dated and returned

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    C. Check all current conditions, which apply to you. Check “No” for others:

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  • COVID-19 Related Questions

  • If you answer YES to any of these questions, please contact me and I will happily reschedule you.

    Office Kindness Policy (Version 1.0)

    • I will wait in my car to receive a text message that it is safe to come into the building and treatment room.
    • I will wear a mask into the office and treatment room. Should I forget my mask, I will text Matt to let him know.
    • I will wear a mask as I leav e the office from the treatment room.
    • I will wear a mask in the common areas of the office.
    • I will wash my hands after using the restroom.
  • This is an expression of kindness and respect. To assure the safety of those Matthew share’s the room and office with.

  • I understand that Matthew Howe of Touch Education, LLC will provide a licensed massage and/or bodywork session. The therapy provided will fall under the scope of a Licensed Professional Health Care Practitioner. I release the practitioner from all liability due to injury or other causes resulting from the treatment. I expressly give permission for the session(s) I receive, and I understand that these services are not a substitute for medical care. I have stated all medical conditions of which I am aware, and I will notify Matthew Howe of Touch Education, LLC of any changes in my health status.

    I understand that I am responsible for all fees associated with this service and agree to pay at the time of service rendered.

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  • 407.308.2110

    Matthew Howe, BCMTB, LMT, ICST

    Nicole Howe, LMT, ICST, RYT, Pediatric Specialist

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