New Patient Relaxation Massage Form

Save time and relax sooner! Complete your Relaxation Massage New Patient Form online before your appointment so you can simply arrive, unwind, and enjoy your massage.

Step 1

Fill out your details to begin your Relaxation journey towards wellness at the House of Massage in Cambridge.

Step 2

Submit your completed form before your first visit, ensuring seamless integration into your wellness journey.

Step 3

Relax in our tranquil setting as you experience the benefits of Cambridge Relaxation Massage at the House of Massage.

First Name

Surname

Email

Tel Number

Occupation

Date of Birth

How did you hear about us? Friend/Google/Facebook/Fresha

Have you had previous massage therapy? Yes/No

What type of pressure to you prefer?

Do you exercise regularly? Yes/No

What type of exercise do you do?

Are you currently on any medication that could affect the massage?

If yes, please explain?

Do you have any of the following? If so, please tick:

If you have ticked any of the above, please explain:

Are there any other health conditions I should be aware of?

Any issues with your back? Yes/No (please explain)

I understand that the massage therapy that I am given is for the purpose of stress reduction relief from muscular tension or spasm, and/or improving circulation. I understand that a Relaxation Massage Therapist neither diagnoses illness, disease or any other medical, physical, or mental disorders; nor performs any spinal manipulations. I am responsible for consulting a qualified physician for any physical ailment I may have.

Signature: (First Name & Surname)

Date signed:

Address

This site is protected by reCAPTCHA and the Google
Privacy Policy and Terms of Service apply.

Message Sent.

Get in Touch

11 Carnation Court, Cambridge 3434

houseofmassagenz@gmail.com

Tel: 021 08256250

New Patient Relaxation Massage Form

Step 1

Step 2

Step 3

Follow us

Get in Touch