Melissa Muguruza Weaver, LMT

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Required Forms

The forms described below should be completed prior to your first appointment. You may complete them in advance and bring them with you. Copies of these forms are also available upon arrival.

Health Information Form

It is important for your therapist to know your health conditions as there are situations when it would not be advisable to receive local or general massage.
health_information_form.pdf
File Size: 756 kb
File Type: pdf
Download File

Client Information Form

This provides your therapist with needed contact information as well as your goals for treatment.
client_information_form_2.doc
File Size: 29 kb
File Type: doc
Download File

Client Policies and Procedures

This form sets expectations of treatment sessions.
client_policies_and_procedures_rev_11-1.doc
File Size: 31 kb
File Type: doc
Download File


Other Forms

Physician Order

This may be used by your physician to prescribe medical massage treatments. Please have your physician print, complete, and return it to your therapist for your file. Completing this form will remove applicable sales tax.
physician_order.doc
File Size: 25 kb
File Type: doc
Download File

 Pregnancy Questionnaire

Women receiving pre-natal massage will be asked to complete this form prior to each pregnancy massage they receive.
pregnancy_questionaire.doc
File Size: 29 kb
File Type: doc
Download File

© 2008 Melissa Muguruza Weaver, LMT. All rights reserved.