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Fauntleroy chiropractic MASSAGE THERAPY Confidential Patient Information ABOUT YOU COMPLAINTS (Please circle areas) Today's Date FRONT BACK Circle what you feel: Name SSN Birth date M F / / Sharp
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How to fill out a massage intake form - Fauntleroy:

01
Start by entering your personal information such as your name, address, phone number, and email. This will ensure that the massage therapist can contact you if needed.
02
Provide any relevant medical history, including any current or past injuries, surgeries, or medical conditions. This information is crucial for the massage therapist to determine the appropriate massage techniques and any precautions that need to be taken.
03
Indicate any medications you are currently taking. Certain medications may affect your response to massage, so it is important for the therapist to be aware of them.
04
Include any specific areas of concern or areas in which you are experiencing discomfort. This will help the massage therapist tailor the session to address your specific needs.
05
Specify the type of pressure and focus you prefer during the massage. Some individuals prefer deep tissue massages, while others may prefer a lighter touch. Additionally, you can indicate whether you would like the therapist to focus on specific areas or if you prefer a full-body massage.
06
Mention any allergies or sensitivities you may have. This is important as massage oils and lotions may contain ingredients that could cause an allergic reaction.

Who needs a massage intake form - Fauntleroy:

01
Individuals seeking a massage therapy session at the Fauntleroy Massage Clinic.
02
People with specific areas of concern or discomfort who require specialized attention during the massage.
03
Individuals with a history of medical conditions, injuries, or surgeries that may affect their response to massage.
04
Those who are taking medications that may interact with massage therapy.
05
People who have allergies or sensitivities to specific ingredients used in massage oils and lotions.
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Massage intake - fauntleroy is a form or questionnaire that collects information about a client's health history, preferences, and goals before a massage session.
The client receiving the massage is typically required to fill out the massage intake - fauntleroy form.
To fill out a massage intake - fauntleroy form, the client must provide accurate information about their health history, any current issues or concerns, and their goals for the massage session.
The purpose of a massage intake - fauntleroy form is to ensure that the massage therapist has all the necessary information to safely and effectively perform a massage on the client.
Information such as medical history, current health concerns, allergies, areas of pain or tension, and goals for the massage session must be reported on a massage intake - fauntleroy form.
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