Healing
Oasis
Total Body Therapy
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Home
Services
Hours
Location
FAQ
Contact
Book Now
Healing
Oasis
Total Body Therapy
Client Intake Form
Welcome! Please complete this form before your appointment. Your information is kept confidential.
Contact & Basics
Full Name
Email
Phone
Date of Birth
Mailing Address
Emergency Contact Name
Emergency Contact Phone
Health History
Current Medical Conditions
Current Medications
Allergies
Recent Surgeries
Pregnancy Status
N/A
No
Yes
Pain Areas (where in your body)
Current Pain Scale (0–10)
Massage Preferences
Pressure Preference
Light
Medium
Firm
Deep
Areas to Focus On
Areas to Avoid
Music Preference (optional)
Aromatherapy
Yes
No
Prior Massage Experience
None
Some
Regular
Consent & Signature
Informed consent:
I voluntarily consent to receive massage therapy. I understand that massage is provided for stress reduction, relaxation, relief from muscular tension, and improvement of circulation — not as a substitute for medical care.
Cancellation policy:
I understand that I am responsible for arriving on time and that cancellations made less than 24 hours before my appointment may be subject to a fee.
Type your full name as signature
Date
Submit Intake Form
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