Initial Massage Intake Form "*" indicates required fields Full name:* DOB:* Past medical history including surgeries:* Pressure:* Soft Medium Firm Session preference:* Remedial Relaxation Both Open to acupuncture or cupping (Bookings with Louisa only):* Yes No Are you pregnant? (Bookings with Sarah only)* Yes No Area of focus for first massage eg. Neck, lower back:* Signature:*Date:* DD slash MM slash YYYY Δ Get in touch today We look forward to working with you! 0466 785 820