Crystal A. Howard
Licensed Massage Therapist (MA 29672) / Esthetician / Waxing Specialist / AP Certified Sugaring Practitioner

Client Forms

ALL clients are required to complete a Health History form.  This gives me an opportunity to understand any health issues you may have and determine if there are any contra-indications for treatment.  It also allows you to inform me of current problems that will be addressed during treatment.  Please print form, fill it out, and bring with you to your first appointment.

First-time Client Health History form

Some clients have medical issues that can be of serious concern.  For these individuals, it is necessary to ensure that their attending physician approve of receiving massage treatment and provide additional information regarding patient's illness/progress.  IF REQUESTED, you will need to print the Physician's Permission form, have your doctor fill it out, and bring it with you.

Physician's Permission form

If your doctor recommends treatment for a specific problem or particular area, the Physician's Referral Form is used.  This form is also useful if a client's insurance reimburses them for massage treatments - this usually accompanies any invoice submitted to insurance to show medical necessity.  IF REQUESTED, please print form, have your doctor fill it out and bring it with you.

Physician's Referral form

Let me know how I'm doing!

Client Feedback form

© Copyright 2017 Crystal A. Howard. All rights reserved.