Kokoro Massage -- Client Forms
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Before your first appointment at Kokoro Massage, there is important paperwork that needs to be completed. New clients are required to fill out a health intake form that details their health history and current conditions. New clients must also read and understand Kokoro Massage's policies and procedures so that they can sign an informed consent form. These records will be kept securely on file and client confidentiality always ensured as mandated by HIPPA.

Most of my intake process is now online via the secure and HIPPA-compliant service, intakeQ. I will send you required forms via e-mail when you make an appointment and you can fill them out and submit them online before and after you come in. This not only ensures the least likely spread of COVID-19 and other infectious diseases, but also gets you on the table faster and allows for more of the session to be dedicated to on-the-table treatment.

If you are unable or unwilling to use the online forms, you may print them out (below) and bring them in. Let me know if you have any questions about the forms, online or off.


DOWNLOAD & PRINT:
Health Intake Form
Informed Consent Form
COVID-19 Agreement Form (prior to every session)
Session Goals Intake (prior to every session)
Session Follow-Up Form (after every session)
Policies & Procedures (for your reference)
Chest Drape Consent Form (optional)
Gift Certificate Order Form
Parental Consent Form for Minors

 

CLICK HERE FOR IMPORTANT COVID-19 INFO




By appointment only. Please schedule online, or call/text.

Phone:

(360)306-0191

E-Mail:

lindsey@kokoromassage.net

Location:

1140 10th Street, Suite #214
Bellingham, Washington 98225
- Map & Directions -

Hours of Operation:

Tues, Weds, Thurs, Fri
8AM-7:30PM


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Kokoro Massage website designed by
Lindsey Frazier 2019. All Rights Reserved.

Photography
Beatrice Harper
Daniel Ritchie
Lindsey Frazier

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