Please complete and submit this form before your appointment, so we can spend your appointment time on your massage and facial instead of paperwork! Your information is confidential, and will be submitted securely to me. Click the "Submit" button and wait for the next page to pop up, which thanks you, confirming that your information has been submitted.
The following information will be used to plan a safe and effective massage or skincare service for you, and is held in confidence in accordance with federal law. Please answer completely. Required questions (those with the asterisk) must be answered.