Specializing in Medical Massage
Chronic & Acute Pain Management
Serving Greater San Diego
~ We accept FSA and HSA cards ~
Thank you for scheduling!
New Clients - Please fill out intake form below before your appointment.
MASSAGE CLIENT INTAKE FORM
Please complete this intake form before the day of your massage.
Massage therapy by Louise Hughes is a therapeutic treatment. I need to understand your lifestyle, physiology, medical issues, needs and goals to provide the proper treatment.

"Karl Jung, one of the pioneers of modern psychology, believed that if you want to see how something is going to unfold, look at how it starts. If this idea were applied to massage, then the focus would be on the intake process, which is the start of a bodywork session. It is the foundation on which the massage sits. The right massage can only come from the right information.

Once a therapist has the client's health information, the next step is knowing what to do with it.
A plan will be crafted based on what the client is experiencing."

- Excerpt from Medicine Hands: Massage Therapy for People with Cancer by Gayle MacDonald
Personal Information



History
Have you received massage therapy before?
Goals for massage therapy today?
Preferred type of touch
Preferred level of talking during massage


Do You Have Any of the Following Today?
Check All That Apply


Select Areas of Discomfort
Check All That Apply


Acknowledgement and Release of Liability
Made on
Tilda