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Health Questionnaire from the Massage Therapists Association

Please complete our health questionnaire before your massage therapy session. Your information remains confidential and ensures a safe, personalized treatment.

    Personal Information

    Phone:

    Date of birth

    Occupation

    General Information

    Do you engage in hobbies or recreational activities?

    Do you practice any sports?

    Have you ever received a massage before?

    Approximate Date

    What type of massage?

    What do you prefer during a massage?

    Reason for Consultation

    What brings you to massage therapy?

    What are you feeling?

    Since when?

    Do you suffer from an injury or inflammation?

    Have you consulted a healthcare professional about this?

    Are you currently being treated / Have you been treated?

    Pregnancy and Menstrual Cycle

    Are you pregnant?

    Expected due date

    Is your menstrual cycle:


    ×
    🎉 Special Relaxation Offer!
    Enjoy our relaxing massage and receive an additional 15 minutes for free for even more relaxation.
     
    Don’t miss this chance to treat yourself!
    Book now and savor every minute!
    Book now and savor every minute!
    ×
    🎉 Special Relaxation Offer!
    Enjoy our relaxing massage and receive an additional 15 minutes for free for even more relaxation.
     
    Don’t miss this chance to treat yourself!
    Book now and savor every minute!
    Book now and savor every minute!
    Oasis Massothérapie
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