Thank You For Booking​ With, Heavenly hands massage therapy & Spa

First-time clients must complete our New Client Online Intake & send a copy of their photo ID to our company's email address immediately after booking to verify their identity. You can complete both steps below. A Covid-19 Pre-screening questionnaire will be sent to your cell phone, the form must be completed 1 hour before your appointment, or your appointment will be cancelled, your temperature will also be taken with our contact-less thermometer, if your temperature is high, your appointment will be cancelled. Heavenly Hands will take multiple safety precautions to ensure your safety, such as contactless temperature checks, pre-screening questions, gloves during massage sessions, high-grade cleaning products, disposable massage face cradle covers, and use of masks. If you have any questions, call/text (813) 731-6111,    Thank you!

Click Here to Email a Copy of your I.D.

*MANDATORY SAFETY POLICY*

Confidential  | Online New Client Intake 

This form must be completed before your scheduled appointment.

Head/Neck Conditions
Check all that apply
Cardiovascular Conditions
Check all that apply
Respiratory Conditions
Skin & Infection Conditions
Nervous System
Musculoskeletal Conditions
Reproductive Conditions
Other Conditions
I hereby state that, to the best of my knowledge, my answers to the above questions are correct. I agree and consent to assessment and treatment. I understand that my personal health information will be collected. I understand that all information that I provide will be kept confidential unless required by law. I understand and consent that my medical information may be shared by the various care providers involved in my care and treatment. *
I understand that massage therapy is provided for stress reduction, relaxation, relief from muscular tension, and improvement of circulation and energy flow. If I experience pain or discomfort during the session, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort. I will not hold my therapist or the company responsible for any pain or discomfort I experience during or after the session. I understand that the services offered today are not a substitute for medical care. I understand that my therapist is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness. I affirm that I have notified my therapist of all known medical conditions and injuries. I agree to inform the therapist of any changes in my health and medical condition. I understand that there shall be no liability on the company or therapist’s part should I forget to do so. I understand that massage is entirely therapeutic and non-sexual in nature. By signing this release, I hereby waive and release my therapist & Heavenly Hands Massage Therapy & Spa from any and all liability, past, present, and future relating to massage therapy and bodywork. I have received the policy statement, and have read and agree to the policies therein.
Leave this box empty, signature will be completed in-person.
This site uses Google reCAPTCHA technology to fight spam. Your use of reCAPTCHA is subject to Google's Privacy Policy and Terms of Service.

Thank you! Your New Client Intake was sent successfully.
0
/
Lightbox image