Lorraine Rodriguez, Licensed Massage Therapist
Relax & Rejuvenate Yourself

Client Forms

Because each person is different, and there may be some special needs, you will be asked to fill out a brief health history form.  We will then discuss any issues you may have, then create a therapy plan. 

All health forms are kept confidential and locked in a filling cabinet.


First-time Client Health History form
Screening Questionnaire form
Body Map for Clients
Client Feedback form
Physician's Permission form
Physician's Referral form

Associated Bodywork & Massage Professionals
© Copyright 2017  Lorraine Rodriguez, Licensed Massage Therapist.  All rights reserved.