Client Forms

 

Health History, Injury Recall, and Informed Consent forms must be filled out prior to receiving massage and/or bodywork.

Completing these forms ahead of time will allow a more relaxed session, with less time spent going over paperwork.

If you are not able to finish the forms prior to your appointment, please arrive 15 minutes early to allow time for completion.

Sauna Release only needs to be completed if you will be utilizing the sauna.


 
Health History Form Soteria Wellness Appleton

Health History Form

Please complete a Health History form prior to your first session, after a significant change in your health due to illness or injury, and annually thereafter. You may add a separate page if needed for more complex histories and/or medication lists.

Injury Recall Form Soteria Wellness Appleton

Injury Recall Form

Please complete this form before your first visit and after any injury, surgery or accident. Use a red pen for current areas of pain/tension and a blue pen for past areas of injury, surgery or disease process.

Informed Consent Form Soteria Wellness Appleton

Informed Consent Form

This form gives us permission to work with you or your dependent and is updated annually. Please note the special section for prenatal and pediatric care and the opportunity to sign up for or decline monthly email newsletters.

Infrared Sauna Release Form Soteria Wellness Appleton

Infrared Sauna Release Form

Please carefully read the sauna release prior to scheduling to ensure that our infrared sauna will be a safe option for your unique situation.