Home
About
Services
Appointments
Contact
Intake Form
Menu
Home
About
Services
Appointments
Contact
Intake Form
Intake Form
Date of Birth
What did you like about your last massage?
What did you dislike about your last massage?
What is your current occupation?
Do you experience chronic pain or tension?
Yes
No
Have you had any recent injuries, or an injury that has caused chronic pain?
Yes
No
Please describe your pain and/or previous injuries
How did you hear about Canyon Massage Therapy?
Select Your Choice
Phone
Facebook
Google
Friend
Other
Do you have any goals for your massage session?
Is there any other information you think would be helpful for me to know, that wasn't previously listed?
Type of music you prefer to listen to during a massage?
Aromatherapy Scent Preference
Any scent
Lavender
Peppermint
No scent
Is topical CBD ok?
Yes
No
Not Sure
Name
Email
Would you like to join the mailing list for promotions and updates?
Yes
Canyon Massage Therapy Cancellation Policy
24 hours notice is required to cancel or reschedule an appointment. Failure to cancel appointments at least 24 hours in advance or failure to show up for your appointment will result in a charge of 100% of the scheduled appointment fee.
Send