What type pressure(s) do you prefer during a massage and bodywork treatment? Please check all that apply.

Please check off any of the following essential oils, if you think you may or have any known allergies or oppositions to them. You may select more than one, but please select "None," if not applicable. (Oils purchased from YoungLiving.com)

Do you have a preference on whether lotions or oils are used?

Do you have any problems with being partially exposed during a treatment? Note that during any treatment, a client is covered completely under a sheet wearing his or her under garments. Only the area being worked on is partially exposed to the therapist. Unless they prefer to be fully clothed during a treatment, then a sheet would not be needed.

Do you have any physical limitations that prevent you from lying on a table? All treatments, except Chair and Focused, are typically performed using a table. This gives the therapist greater access to massage and/or treat set muscle groups of the body. Unless you have a physical limitation, please select "No."

Do you experience any significant pain or limited range of motion with your muscles located in the follow areas? If so, please specify which muscle area or areas. You may select more than one, but please select “None,” if not applicable.

Do you feel energy blockages (i.e. recent surgery or other causes) in any of the following areas? Note, each area corresponds to a different Chakra energy center. You may select more than one, but please select "None," if not applicable.

Have you had any recent sleep irregularities or excessive tiredness? If so, during what times does this happen most often? Note, these times correspond to meridian patterns according to the Chinese Clock. Select "No Irregularities," if not applicable.

Have you had an "out of the ordinary" food cravings lately? If so, choose the strongest craving. Note, each taste is associated with one of the 5 Elements. Select “No,” if not applicable.

Have you been feeling "overly" emotional? If so, which one stands out most? Note, each emotion is associated with one of the 5 Elements. Select "No," if not applicable.