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 alan@intuitivebodywork.net. Thanks!

Prenatal Massage Addendum

If you are pregnant, please complete this form in addition to the Client Intake Form.

Intake Form

If you're a first-time client, please print this form, complete it, and bring it along to our first session.

Breast Massage Addendum

If you wish to discuss lymphatic breast massage, please complete this form in addition to the Client Intake Form

Physician Referral for Medical Massage

If you have been referred by Medical Massage, please ask your physician to submit this referral/ prescription form.