Forms

 

New Client Forms

If this is your first appointment with us, please print, complete and sign these forms. If you do not have access to a printer, your therapist will provide these forms prior to treatment. Your therapist will spend a few minutes reviewing these with you. This will not intrude on your actual massage time.

Chair Massage Form

Please print, complete and sign this form prior to our appointment. If you do not have access to a printer, your therapist will provide this form prior to treatment. Your therapist will spend a few minutes reviewing this with you. This will not intrude on your actual massage time.

Oncology Forms

Please print, complete and sign these forms prior to our appointment. Have your Oncologist/Healthcare Provider complete the medical referral form prior to our appointment. If you do not have access to a printer, please call us at 808.729.6133 or email us at info@kneadedbliss.com. We will mail you the necessary forms.

Medical Information Release Form

If you are currently under the care of a Physician or Chiropractor, please complete this form and give to your healthcare provider. This form allows us to speak directly to your Physician or Chiropractor in order to craft the most appropriate massage session. We follow HIPAA and as such, all information provided is strictly confidential. For more information on HIPAA, click here.

Physician Referral Form

If you are currently under the care of a physician or chiropractor, please have your healthcare provider complete this form prior to our appointment. Without this form, massage may not be advisable or permissible. Our massage therapists reserve the right to refuse treatment.

 

 

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