Client Intake & Referral Forms
Intuitive Bodywork Massage Therapy
Alan Jordan, LMT, NCTMB & Helga Jensen, LMT, NCTMB
The forms below are provided for your convenience. You are not required to complete the intake forms prior to your first visit but if you wish to complete them at home, here they are!
We look to forward to your visit. If you have any questions or concerns prior to your appointment please contact us at 717-884-9568 or by Email at firstname.lastname@example.org. Thanks!
If you are pregnant, please complete this form in addition to the Client Intake Form.
If you're a first-time client, please print this form, complete it, and bring it along to our first session.
If you wish to discuss lymphatic breast massage, please complete this form in addition to the Client Intake Form
If you have been referred by Medical Massage, please ask your physician to submit this referral/ prescription form.
Note: To download Adobe Acrobat Reader for free, click here.