Massage in Wanaka Questionnaire for new clients:

Name

First Name

Last Name

Phone number

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you on any medications that we should know about?

Do you have a heart pacemaker or any other battery operated or electrical implant?

Are you pregnant or breastfeeding?

Are you currently taking a course of chemotherapy treatment?

What are you coming to Massage in Wanaka for?