Harmony Massage Therapy Intake Form Page 2
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2Please mark with an (X) areas you feel pain or tension in your body right now. Sometimes it helps to
close your eyes and breathe, and become aware of the areas that you may want worked on today.
Thank you for coming in today! Enjoy your massage!!
Notes for
therapist:__________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_____________________________
Overall plan/recommendations:
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