New client intake form Theraputic mobile massage by Melissa Fernandez MT126110 Logo
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    To request an appointment please fill in your details and I will confirm with you. 60 min massage $140. 90 min for $170. 346.282.1006 MA93231-Florida, MT 126110- Texas
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  • I realize that I, the client, am responsible for keeping my massage therapist informed of any condition or health issue that may affect this bodywork session. The information shared on this form and during each session is kept confidential between the therapist and myself. I, the client, understand that massage is a form of health and wellness maintenance, which may facilitate various types of healing, however, is not intended to replace medical treatment if otherwise necessary.

    I provide non-sexual massage only. Do not contact me for non therapeutic services.

     

     

    I understand and agree to the terms above.

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