The Intake

When a new client visits me for the first time I need tot do an intake.
With the intake-information you share important issues about your physical condition and your health, with the masseur.
The masseur can adjust the massage taking these issues in account

For example: if you broke a bone short ago, the masseur will avoid this place or be more carefull at this place.

Please fill in the form and press ‘send’.

Thank you

Which of the following options apply for you? (no choice or multiple choises possibel)

STATEMENT OF APROVAL

With filling in and signing this form (by filling in my name, residence and date) I declare that I have understood all questions and fillid in thruthfully. This form is valid from date of signing and without an end-date, for future massage. Changes will be reported directly to the masseur.

I understand the massage is for purpose of relaxation and change of tension of the muscles. It is not a replacement from any medical investigation or treatment or diagnoses. This massage can nog be seen as a medical treatment.

The massage is at my own risk. I will not hold the masseur accountable for any consequences or side effects due to the massage. I will inform the masseur directly during the massage when I experience pain or discomfort.

I agree that my personal information is kept (only on paper, not digital)

I agree to the terms and conditions of Massagehands.

When the form is send (press the green button) it will arrive in the email of Massagehands. The information is being printed and before the massage starts, we will discuss it shortly, if necessary. You don't have to bring the form/information yourself

Thank you for your information. I will respond as soon as possible by mail.
There was a problem during the sending of the form. Please inform me by email, so I can fix the problem. Thank you