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Client Forms

If you chose to do so, you can fill out the following forms before your first visit.  This will make your massage day even more relaxing when you don't have to worry about that pesky paperwork! Just download, print, fill them out, and bring them with you!




First Visit

This form helps me get a little more information about you, why you want massage, and the goals you want to meet. This helps us come up with your massage plan!

Health Information

First Visit/Yearly

This helps me get to know you, and what's going on in  your body! This will also let me know of any medications you are on, as well as symptoms you are experiencing!

Health Status Update

Every Visit

This form allows you to tell me exactly where you are experiencing pain, soreness, & tenderness.  It helps me come up with a plan that will help you the most!

Client Feedback

Every Visit

I really appreciate feedback from all of my clients!  If you want to fill this out and bring it back to me after your appointment with me, you can!  I am always grateful for new ideas!


(775) 354-5725

221 SW Noel Street, Lee's Summit, MO 64063

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©2019 by Fiorire Wellness.