Touch of Life Massage and Doula Care
Take Time Out to Relax

Client Forms

Please feel free to complete the following forms prior to your Initial Visit to reduce the time that is required for completing paperwork. These forms are not required to be filled out on subsequent visits unless requested by the therapist.

Required Forms:
First-time Client Health History Information form (printable)
First-time Client Health History Information form (electronic)
Billing Information form (Required for insurance billing only)

Optional Forms:
Screening Questionnaire form (printable)
Screening Questionnaire form (electronic)
Body Map for Clients (electronic)

Physician Forms:
Physician's Permission form (If required)
Physician's Referral form (If required - printable)
Physician's Referral form (If required - electronic)

You can print and complete any of these forms to bring with you to your visit, or for any of our forms that are electronic PDF files, you can also download and complete the form using Adobe Acrobat Reader, then print or email them to prior to your visit.

After your visit, you can fill out the following form to let us know how we did. If you don't want to print it and bring it with you, please feel free to request one upon completion of your visit.
Client Feedback form