THERA-MED MASSAGE; HTTM, LLC   

Changing lives in a meaningful way; for continuous improvement of physical freedom from pain!

NEW CLIENT FORMS

PLEASE PRINT AND COMPLETE FORMS PRIOR TO TREATMENT SESSION


This will save valuable treatment time by completing the forms prior to treatment. Please complete all that applies to you and the more forthright you can be the better I can treat and serve you.


Medications, medical conditions, injuries and surgeries are all very important information even if they are from long ago, so please disclose these details. Your information is kept safe and private.


***IMPORTANT SAME DAY CANCELLATION/NO SHOW DOES RESULT IN CHARGE FOR FULL AMOUNT OF SERVICE INCLUDING ANY AND ALL DISCOUNT SITES****