Please complete this form prior to your massage treatment. Thank you so much and we look forward to seeing you soon!

Preliminary Client Intake

    Full Name:*


    Phone Number:*



    Company / Job Title / Brief Description of work*:

    Notes (Area of need, recent injuries, surgeries, allergies, and diseases or History with covid or any recent complications)*:

    I consent to receive massage, bodywork, fitness or other wellness solutions and services from SMART Bodywork® team or practitioners (et. al.), and if ever a dispute arises that requires and intermediary, I agree to seek arbitration and/or mediation between parties rather than filing a lawsuit.*

    *required field

    SMART Bodywork® Massage Services

    If you or someone you know is dealing with a sports or medical injury, give the SMART Bodywork® team of amazing massage therapists a try. With the many attributes, experiences and educations we are committed to helping you all the way through life achievements! Look forward to seeing you soon!



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