Client Intake Form

Help me to Best serve YOU!

Are you currently pregnant?
Do you have any allergies or sensitivities?
Have you had a professional massage before?
What pressure do you prefer?
Are you open to receiving any energy work to help restore balance to the subtle body? Reiki and/or Polarity Therapy.
What type of massage are you seeking?
What pressure do you prefer?
How would you rate your nutrition?UnhealthyUnhealthyUnhealthy/NutritionistNutritionistNutritionistHow would you rate your nutrition?
What is your current lifestyle?
What are you most excited to learn about Yoga?o receiving any energy work to help restore balance to the subtle body? Reiki and/or Polarity Therapy.
What do you struggle most with?

Thanks for submitting!