Health History Form

I am thrilled that you are considering my services and and would like to thank you for your trust.

 

Before your first appointment, you will need to fill out a client intake form. As you will see, it is pretty in-depth. It helps me to get a good overview over your health history and establish your treatment goals.

 

You can print the forms right from this page. Simply follow the link below, print the pages, fill them out, and bring them to your appointment. Alternatively, you can fill out the form on the day of your first appointment, but please plan on arriving 10 minutes early to complete the paperwork. 

 


 

Should you have any concerns about your health, please discuss them with your primary care physician before making an appointment for a treatment. 

 

Please, also take a moment to familiarize yourself with how to dress for and what to expect from a treatment session at Eastside Bodywork and please read through our policies

 

I look forward to meeting YOU!

Eastside Bodywork LLC                                                                                                                                                   Simone Holderbach, LMT  

11417 124th Ave NE, Suite 101, Kirkland, WA 98033                                                                                        Washington License # MA 60486695

Phone: (425) 236-9900                                                                                                                              Email: simone@eastsidebodywork.com                                                                                                                                                                        



© 2017 by Eastside Bodywork LLC     

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