Please check all that apply and provide details where relevant.
Medications & Supplements
Pain & Sensitivity Awareness
Please check any areas that are painful, sensitive, or should be avoided:
Sensory & Comfort Preferences (Optional but Encouraged)
This helps us tailor the session to your nervous system.
Consent & Acknowledgment
Please read and sign below.
I understand that massage therapy and bodywork are not a substitute for medical diagnosis or treatment.
I have disclosed all relevant health information to the best of my knowledge.
I understand I may stop or request changes to the session at any time.
I consent to receive therapeutic bodywork from Alfa Therapy LLC.
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