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Thanks for choosing S.A.M. clinic for your massage. To serve you better please download, read and sign the document below and send them to us proier than your massage session. try to give us sometime to read your documnt and find the best treatment plan for you.

S.A.M clinic intake form

Step Above Massage — Client Intake Form

Please complete this form before your first appointment. It helps us tailor your session safely.

Contact InformationFull Name * Email * Phone * Emergency Contact Name Emergency Contact Phone Occupation

Visit DetailsReason for Visit / Goals for This SessionAreas of Pain, Tension, or InjuryPreferred Pressure Have you had a professional massage before?

Yes No

Health HistoryCurrent Medical ConditionsCurrent Medications / SupplementsAllergies (oils, lotions, latex, etc.)Recent Surgeries or InjuriesAre you currently pregnant?

Yes No N/A

Anything else the therapist should know?

Consent I understand massage therapy is provided for relaxation and/or therapeutic purposes and is not a substitute for medical care. I have disclosed all relevant health information above and consent to receive massage therapy. * Type your full name as your signature *

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Step Above Massage — Client Intake Form

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