Client Intake Form | Inner Luxury

First name

Last name

Phone

Address

Any Specific Instructions or landmarks that might assist our massage specialist in finding your home:

Any current or past injuries, chronic illness, or allergies?

Massage preferences: Please let us know if there is any areas you would like our massage specialist to focus on more

Would you prefer light, medium or deep pressure ?

What is your goal? (e.g. Relaxation, pain relief)

Lifestyle Factors: Please share how your stress levels are and physical activity levels?

Any additional Notes:

Do you have pets at home? If so please share what type

Will our bodyworker have to travel up stairs to get to your home?

Is there free parking around your home? Please note that we do require reimbursement on any parking charges incurred.

Do you have a preference on the gender of your massage specialist?

How did you hear about us?

I agree to the terms & Conditions https://docs.google.com/document/d/1YbEAYDT5Wfw23gO9QLVacbtZ9Peu0I0eg0XGDcNcg1g/edit

We maintain a Zero-tolerance policy for any inappropriate behavior during massage sessions. Our massage specialists adhere to the highest standards of professionalism, and any misconduct will result in the immediate termination of the massage session.