Health History Form

A complete and accurate health history is very important to ensure that Kelly has a complete picture of your health and to make sure that Massage Therapy is safe for you to receive. If you are a Doula client, it is just as important to have the same picture of your health status so please fill out all areas that apply.

Your massage treatment will begin on the assumption that you have provided an accurate and up to date health history. Kelly will go over this form before your treatment begins. All information that you provide is kept confidential and can only be shared with your written consent.

Download a Printable Form