Waller Therapeutic Massage
Client Forms

Waller Therapeutic Massage

Glenn H. Waller LMT

Please print and fill out the first two forms before your first visit.


If you have any health issues (contraindications) that could possibly be aggravated by a massage, print the last form so I know that your doctor has approved you receiving a massage. This physician's permission form is especially important if you are pregnant. 


Health Information form
Health Status Update form
Physician's Permission form

Associated Bodywork & Massage Professionals
© Copyright 2017 Waller Therapeutic Massage. All rights reserved.