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Massage Therapy Intake Form Date of Initial Visit Name Phone DOB Address City/State/Zip Email Occupation Emergency Contact Please answer the following questions to the best of your knowledge. This information will be used to help plan safe massage sessions. Have you had a professional massage before If yes how often do you receive massage therapy Yes No 2. Do you have any difficulty lying on your front back or side If yes please explain* 3. Do you sit for long hours workstation driving...
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