Thai Bodywork Intake Form

Please complete the form below so we can get started with your bodywork session(s)!

It will only take a couple minutes and will help me get a better sense of what you're looking for in your bodywork session. Thanks for being as thorough as possible. I look forward to working with you.

Name

First Name

Last Name

Email Address

Phone

Have you ever received Thai Bodywork?

What do you hope to gain from the bodywork session? Please check all that apply

Relaxation/stress reduction

Increase flexibility

Decrease pain

Increase circulation

Relieve tension

Improve sleep

Heal or manage an injury or trauma

Where would you like the session to take place?

Please list any injuries, traumas or other health concerns and the duration of current issue

If you are seeking private yoga sessions for therapy, please indicate whether you are seeing another professional for your health concerns

Please describe your lifestyle (ex. job, energy level, diet, elimination, hobbies, sleep)

Where do you hold tension in your body?

Anything else I should know?

Thai Bodywork Intake Form

Please complete the form below so we can get started with your bodywork session(s)!

Stay in touch!

© Lilli Markle 2020