Health History Form

It is important for your therapist to know and understand certain information pertaining to your health history before providing massage and bodywork so that they can effectively assess your current health conditions and plan your personalized, therapeutic massage session. By providing detailed information, you and your service provider can insure that all necessary precautions are taken and that you receive the care you need and deserve.

This online Health History form accompanies the online Informed Consent Form. Both forms must be completed and electronically signed by new clients to receive massage or bodywork. Hard copies of both forms are also available at the spa. Please arrive 15 minutes early to your appointment so you have plenty of time to complete your forms and ask any questions that you may have.

We value the information you share with us and will always maintain confidentiality with all given personal information.



By typing my name below, I certify that the information I provided is true, complete, and accurate. I agree to inform my therapist if any of the above information changes at any time. I understand that my massage therapist does not diagnose disease, illness, or prescribe any treatment or medication nor do they provide spinal manipulation. I understand that massage therapy is not a replacement for medical care and I will consult with a qualified physician for any physical ailments that I have. I understand that massage therapy is a therapeutic health aid and will not interpret any information given to me during the session as medical in nature.

Thank you!

We have received your Health History form.

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