Are you currently under medical care?*
Are you currently taking any prescription medication? If so, for what?
We require a 24-hour cancellation notice or appointment rescheduling of all services.
A Charge of 50% of the service will be incurred for all missed appointments.
Please note that this card will only be charged in the case of a same-day cancellation or a no-show appointment, please bring in a separate payment method at the time of your service.
Type of card*
By entering your name, date and signature below, you are effectively providing your signature,
indicating that all the information on this form is true and accurate, to the best of your
Informed Consent and Massage Policies