2 minutes to complete
If you are pregnant, you can get a pregnancy massage once your doctor gives you the approval.
Name
Date
Start time
End time
How did you hear about us?
Are you currently pregnant?
If yes, how many weeks pregnant are you?
Do you have any medical conditions we should be aware of?
Do you have any allergies?
Do you have any injuries or areas of pain?
Is there anything else you would like us to know?