Please Print and sign before our session. Any questions? You can email it to me to richel.pmuir208@gmail.com or text me on my cellphone: (913)-291-4800. See you soon!

Health Information form
Health Information form - COVID-19 Addendum
Screening Questionnaire form
Screening Questionnaire: COVID-19
Client Arrival: Check-In Screening Protocol (COVID-19)
Body Map for Clients
Health Status Update form
Client Feedback form
Physician's Permission form
Physician's Referral form

Massage Consent & Release Form

Please read this information carefully before signing in

I understand this chair or table massage I will receive is not intended as a medical treatment. By signing below, I agree that I am voluntarily receiving this chair or table massage at my own risk and, if I have any questions about such risks, I must discuss them with my doctor first. I agree to release and hold harmless the therapist, its affiliates, and/or, its officers and agents, from any claims related to this chair or table massage, including any illness, flu, or coronavirus, including claims to negligence.

Please Print Name Clearly:                              

Date: