Health History Form

In order to comply with the College of Massage Therapy of Ontario, all Registered Massage Therapists must have clients complete Health History Forms before the treatment commences. Completing the forms ahead of time and arriving on time ensures you will receive your full treatment length. The completion of these forms also ensures your RMT is better equipped to help you with your specific conditions. We require your signature in order to verify your appointment date and fee with your Insurer. Insurance providers call our clinics to verify online submissions.

PLEASE NOTE: Certain information is mandatory on a health history, such as your date of birth (DOB) and your family doctor’s info, if you have one.

To download your copy of the necessary forms, please click the link below.

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First Name*

Last Name*

Phone*

Email*

I am a new client.

Contact preference

Phone

Location*

Therapist

Therapist Gender

Date*

Time Of Day*

Service Length*

What are our goals for this treatment?

I have read and agree with the cancellation & late policies*

I have read and agree with the cancellation & late policies

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