Client Intake Forms

For your convenience, you can print and complete the intake form ahead of time so that you can arrive to your appointment ready to start your session. Please click below on the corresponding intake form. 

This form MUST be completed by all clients only once. If you have not completed this form, it will be required upon your first visit upon my re-opening, whether new or returning.

To be completed each session during the Covid-19 pandemic-
new and returning clients.

For cash-based massage therapy. 
*Ayurvedic massage - must also complete Dosha Questionnaire (below). 

For PIP and L&I claims only. Must have Referral/Prescription from Doctor/Chiropractor and open claim. Call for appt. 

For Life Coaching services only. Free 15-min consultation offered prior to initial session. Call to book. 

Along with the Massage Intake, this must be completed for the Ayurvedic massage, in order to your customize session. Must be completed in advance. Allow 10-20 min to complete.

© 2020 The Healing Compass                

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