FlowState Seattle Massage

New Client Intake Form: Start Your FlowState Massage Journey

Please complete all fields as accurately as possible. Your information is confidential and helps us provide safe and effective treatment.

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Personal Information

Your Health History and Medical Information

Are you taking any medications?

Are you currently pregnant?

Do you suffer from chronic pain?

Have you had any orthopedic injuries?

Please indicate any of the following that apply to you

Massage Information

Have you had a professional massage before?

What type of massage are you seeking?
What pressure do you prefer?

Do you have any allergies or sensitivities?

Are there any areas (feet, face, abdomen, etc.) you do not want massaged?

Consent

By signing below, you agree to the following. 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.

We often share educational material that we consider to be helpful if you are dealing with injury trauma, stiffness due to physical-mental stress or burn out.

Practices like yin yoga, or Qi Gong are great for nervous system reset.

We also often send notifications of same day availability.

Massage therapy on a person's shoulder and upper back

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