Healing Spa Conroe · FM 1488
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Before Your Visit

Massage intake form.

Thank you.

Your form is with us. Your therapist will read it before your session and go over anything worth talking through when you arrive. Nothing else to do — just come in.

Your reference: — keep it with your records.

Book Your Appointment Back to Healing Spa

Fill this out before you come in and your appointment starts on the table instead of at the front desk. It takes about five minutes. Your therapist reads it before your session so the pressure, the oils, and the areas worked are right for you from the first minute.

Prefer paper? You can fill the same form at the front desk when you arrive. Questions before then, call or text (936) 777-4491.

A few required fields are still empty. Please complete your name, phone, date of birth, and check all four boxes at the bottom so your therapist can treat you safely.

Personal information
Medical information

Your therapist uses this to keep you safe and to decide what to avoid. If something does not apply, leave it blank.

Are you taking any medication?
Are you currently pregnant?
Do you suffer from chronic pain?
Have you had any orthopedic injuries?
Please tick anything that applies to you
Massage information
Have you ever had a professional massage?
What are you looking for this visit?
What pressure do you prefer?
Any allergies or sensitivities?

You can change this at any point during the session. Just say so.

Consent and signature

Checking these boxes and typing your name is your electronic signature under the U.S. E-SIGN Act (15 U.S.C. § 7001) and the Texas Uniform Electronic Transactions Act. We record it along with the date, the time, and the exact wording shown above, and keep that with your file. You are agreeing to transact electronically. If you would rather sign on paper, say so at the front desk and we will hand you the printed form.

A parent or guardian must sign for a minor and remain on the premises for the session. See Minors in our terms.

Your form goes straight to the spa and is read by your therapist before your session. Only Healing Spa sees it. We never sell it or share it with anyone else. See our terms.