New Client

Your intake form

Name: Body Harmony Massage
Address: 1272 Taft St, Eugene, OR, 97402, US
Telephone: +1-541-870-9997
Rating: 5

If you’d like to save time, you can fill this out at home before your visit and just bring it in with you.

If you don’t have a printer or prefer to do it when you arrive, that works too.

The intake form is three pages. The last page has the consent and cancellation policy to sign.
If you’d like me to bill your insurance, there’s a section for that at the end.

You can also read my cancellation policy ahead of time. If you have any questions, call or text 541-870-9997.