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BBM Intake Form

Is this your first massage?
What pressure do you prefer?
Do you have any allergies or sensitivities?
Are there any areas (feet, gluteals, etc.) you DO NOT want massaged?
Are you taking any medications?
Have you had any orthopedic injuries in the past year?
Please indicate below if any of the following medical concerns apply to you.

By signing below, you agree to the following statement

- I understand that contraindications for massage do exist and that I must disclose any relevant health information for my own protection and safety as well as the safety of my therapist. I confirm that I have completed this form to the best of my ability and knowledge, and agree to inform my therapist if any of the above information changes at any time. 

Thank You For Submitting!

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