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)


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.</