The "Paperwork"

 

All first time clients must fill out our Consent Form / New Client Information prior to their first massage with us. You can do this before you actually get to our office!

PLEASE DO NOT FILL OUT THE FORM UNTIL YOU HAVE AN APPOINTMENT BOOKED WITH US! FILLING OUT THE FORM DOES NOT SCHEDULE AN APPOINTMENT! PLEASE CALL 614.222.5782 TO SCHEDULE AN APPOINTMENT.

There are two ways of filling out "the paperwork" in advance.

  • Click here to download and print out our form. Just remember to bring it with you on the day of your appointment.

OR

  • Use the online form below. We'll store your form and will have it available on the day of your visit. Make sure when you're completed with the online form that you click the "Send It To In The Bag Massage" button at the very end of the form. How will you know it was successfully sent? You'll be taken to a "Thank You" page after submission.

CONSENT FOR SERVICES

For all clients receiving any massage or reflexology service provided from In The Bag Massage, it is important for you to know that:

  • We are not doctors.
  • We do not practice medicine.
  • We do not diagnose or treat for a specific illness or disorder.
  • We do not prescribe or adjust medication.

Depending on the practitioner you receive your service from, the massage or reflexology session may be a non-therapeutic session meant to relax the body through various stroking techniques.

Both massage and reflexology promote balance and normalization of the body naturally. They reduce stress and bring about relaxation while improving circulation and the delivery of oxygen and nutrients to the cells.

By signing this form, I give my consent to a Massage or Reflexology Session. This consent extends to all sessions received on this or future days. I understand that I may discontinue sessions at any time. If I have been diagnosed by a licensed health professional as having any disease, injury, or other physical or mental condition, I understand that I should inform the person who made the diagnosis about the treatment that I will be receiving and whether I intend to discontinue any treatment or therapy which has been previously ordered, prescribed, or recommended by a licensed health professional. I understand that by discontinuing any such treatment or therapy, I assume responsibility for any negative outcome resulting from discontinuing that treatment or therapy.

Massage and reflexology sessions are not a substitute for medical care. If you are experiencing any specific medical problem and have not seen your medical doctor, we recommend you do so.

Your name. (Typing your name signifies that you are "signing" this form.)

Today's Date:

Date of your appointment:
DO NOT FILL OUT THIS FORM IF YOU DO NOT HAVE AN APPOINTMENT SCHEDULED. Without an appointment, the form WILL be discardeed.

Appointment Location:

Daytime Phone Number

Evening Phone Number

Cell Phone Number

Email Address

Street Address

City

State

Zip Code

Birth Date

Referred By

If you found us by a friend or some other way, would you please tell us who / how you found us?

Please list known health conditions (women, please let us know if you're pregnant, and, if so, how far along.)

How long ago was your last massage?

Reason for getting your massage?

Is there any other information we should be aware of before the session?

We offer an email listing to our clients to let them know of last minute openings in our schedules and special offers. We NEVER sell your name or email address to any third party. Would you like us to add your email address to our listing?