Back to Body
Back to Body
Adriana Rivera, LMT
Book

Complete your intake.

Share a little about you and your body. After you submit, you'll be taken to my scheduler to choose your time — a nonrefundable deposit secures your appointment.

01

Client information

02

Health history

Currently under a physician's care?
Received massage therapy before?
Currently pregnant or possibly pregnant?
03

Allergies & sensitivities

04

Medications

05

Medical conditions

06

Surgeries & injuries

07

Pain & current complaints

How long has this been occurring?
Type of pain
08

Goals for today's session

09

Lifestyle & habits

Water intake
Sleep quality
10

Massage preferences

Pressure preference
Sensitive areas
Preferred session style
11

Informed consent

I understand that massage therapy is for relaxation and therapeutic purposes and is not a substitute for medical diagnosis or treatment. I understand that I should inform my therapist of any medical changes. I understand that I may request modification or stop the session at any time.

After submitting, you'll be taken to Calendly to choose your time and pay your nonrefundable deposit (forfeited for no-call/no-show).