Thank You For Booking​ With, Heavenly Hands Massage Therapy & Spa

First-time clients must complete our New Client Online Intake Form

  • Mobile massage clients must 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.
  • First-time clients at the spa must bring a photo ID to their first appointment to verify their identity, no exceptions.

 A Covid-19 Pre-screening questionnaire will be sent to your cell phone, the form must be completed before your appointment, or your appointment will be canceled, your temperature will also be taken with our contact-less thermometer, if your temperature is 100.4 or higher, your appointment will be canceled. 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 the 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.

Please contact us if you have any questions (813) 447-5701

Company policies and procedures are located on the "Book Now" page, please review them, you will be emailed a copy after booking your appointment.

Please list name of person, social media site, or physician.
Have you had a professional massage before?*
What type of massage pressure do you prefer?*
Are you pregnant?*
Please reschedule to an future date if you are less than 12 weeks pregnant
Do you bruise easily?*
Select your areas of pain*
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 have read the above the policies and procedures of Heavenly Hands Massage Therapy & Spa and I have had the opportunity to question the contents and my therapy. By signing this form, I confirm my consent to treatment and intend this consent to cover the treatment discussed with me and such additional treatment as proposed by my therapist from time to time, to deal with my physical condition and for which I have sought treatment. I understand that at any time I may withdraw my consent and treatment will be stopped. 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 that massage therapy is provided for stress reduction, relaxation, relief from muscular tension, and improvement of circulation. 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. To proceed with receiving treatment, I confirm and understand the following: I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). Furthermore, I understand that COVID-19 is extremely contagious and may be contracted from a variety of sources. I understand COVID-19 has a long incubation period during which the virus carriers may not show symptoms and still be contagious. I understand that I am the decision-maker for my health care needs. To the best of their ability, my practitioner will provide me with information to assist me in making informed choices. This process is often referred to as “informed consent.” It involves my understanding and agreement regarding recommended care and the benefits and risks associated with the provision of health care during a pandemic. Given the current limitations of COVID-19 virus testing, I understand determining who is infected with COVID-19 is exceptionally difficult. I understand that preventative measures and intensified sanitation protocols intended to reduce the spread of COVID-19 have been implemented. However, because this work involves close physical proximity over an extended period of time in a closed space, there may be an elevated risk of disease transmission, including COVID-19. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this treatment and give my permission to you to proceed with providing care. I have been offered a copy of this consent declaration/release of liability waiver and I intend this consent to cover the entire course of care for my present and any future condition(s) for which I seek care from this company, Heavenly Hands Massage Therapy & Spa.*
Leave this box empty, signature will be completed in-person.
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Thank you! Your New Client Intake was sent successfully. Please bring your ID or Drivers License with you to your first appointment so we can verify your identity.
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