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Massage Intake Forms
If you have medical conditions, I would highly recommend you first talk to your doctor if you can receive a massage.
To ensure your safety, filling out the intake forms is required. Additionally, showing your ID before receiving a service is required to meet the new Florida Statutes 480.043 (14)(f). Please download the forms from below, print, fill out and bring them to your first appointment.
If you don't feel well or have the conditions listed below, please reschedule your appointment and/or see your doctor.
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Undiagnosed ongoing medical conditions
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Recent injury or accident (wait 72 hours or until medical clearance is given)
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Recent surgery (until medical clearance is given)
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Fever
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Infectious or Contagious Illnesses, Infections, Viruses, or Diseases including Colds, Covid-19, Influenza, Sinusitis, Tonsillitis, Gastroenteritis, Measles, German Measles, Mumps, Diarrhea (if due to an infectious agent), Chickenpox, Shingles, Ringworm, Mononucleosis (Mono), Scabies, etc.
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Unstable Blood Pressure or Hypertension (High or Low)
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Influence of drugs or alcohol
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Deep Vein Thrombosis (DVT)
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Pitting edema
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Widespread rashes or hives
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Undiagnosed severe, acute pain
Private Tai Chi Lesson Intake and Waiver Form
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