In-Home & Personalized Medical Massage Inquiry
Thoughtfully coordinated care for individuals and families
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Best Way to Contact You
Phone
Email
Either is fine
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Address Where Services Would Take Place
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this location within North Metro Atlanta?
Yes
Not sure
No (I understand services may not be available yet)
Is this care for:
Myself
A loved one
Multiple people in the same household
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Who Will Be Receiving Care
Who will receive services during this visit?
Older adult
Adult
Child or adolescent
Multiple family members
Approximate age range of person(s) receiving care
Under 18
18–40
41–64
65–79
80+
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Care Needs & Considerations
What are the primary reasons you are seeking care?
Chronic pain
Mobility or balance concerns
Neurological condition
Post-surgical or injury recovery
Stress or nervous system regulation
Comfort-focused or supportive care
Caregiver strain
Other (short answer)
Are there any known medical conditions or considerations we should be aware of?
Is the person receiving care currently working with other healthcare providers?
Primary care
Home health
Physical therapy
Occupational therapy
Hospice or palliative care
Other
Not currently
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Service Structure
Are you interested in:
One-time visit
Ongoing care
Family-based visit (multiple people during one appointment)
Not sure yet
Do you have preferred days or times?
What would make this experience feel supportive and successful for you?
I understand this form is an initial inquiry. A Thrive Care Coordinator will review my information and follow up to discuss next steps and availability.
Request In-Home Care
Request In-Home Care
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