Client Forms & Important Information

Please feel free to print these forms and fill them out prior to your first session or show up 10 minutes early to fill out the forms needed.  Treatment/therapy will not be administered without a completed and signed Health Information Form.

NOTE: If you are under a regular Physician’s Care for any reason (i.e. including but not limited to recent surgery, injury, or other medical conditions such as diabetes, fibromyalgia, etc.) please provide the Physician’s Permission Form.

NOTE: If you use any topical skin creams/ointments for medical or other reasons (i.e hormone creams, etc.) PLEASE indicate on your Health Information Form or inform your therapist before treatment/therapy!  Thank you.


Forms for Treatment:

Health Information form *Complete this form for treatment
Body Map for Clients
Health Status Update form
Client Feedback form
Physician’s Permission form
Physician’s Referral form


Products used in treatment:

Coconut Oil

Essential Oils

*During the summer months a massage oil blend may be used (at an additional cost) from Wayne Plantation, located in Scott, AR.  The blend includes sunflower oil (Arkansas produced), fractionated coconut oil, and grape-seed oil, with the option of an essential oil (check with Hannah before your session for essential oil addition).  This blend absorbs quickly, which in turn gives your skin a more natural hydrated feel and greatly reduces the “greasy” oil feel as you head back into the hot sun.