Massage Client Intake Form
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1 Massage Client Intake Frm
2 The Benefits f Massage Massage is an excellent preventive treatment essential fr the maintenance f health and fitness. Preventin is always far better than cure. Nwadays, peple f all ages are increasingly cnsidering natural therapies as a way t encurage an imprved sense f well-being and as a means t a lng, happy and harmnius life free f illness. Peple have been enjying the benefits f massage fr thusands f years. Recrds indicate that it was used in several ancient scieties fr a variety health reasns. Tday, massage still prvides benefits t all the systems f the bdy, sme f which are utlined belw. Benefits t the Nervus System The nervus system is prfundly influenced by the applicatin f massage. The effects f massage may be sthing and sedative, prviding relief frm nervus irritability. Disrders such as insmnia, tensin, headaches and ther stress-related cnditins respnd t the healing pwer f tuch as peace and harmny returns t the trubled mind. Alternatively, the effects f massage n the nerves may be stimulating, prmting an increase in the activity f the muscles, vessels and glands gverned by them. It is invaluable in cases f lethargy and fatigue. Benefits t the Muscular System The muscular system derives enrmus benefits. Muscles maintain a balance in relaxing and cntracting. Sme massage mvements relax and stretch the muscles and sft tissues f the bdy, reducing muscular tensin and cramp. Fibrus tissues, adhesins and ld scar tissue can be brken dwn and cleansed f waste depsits. As muscles cntract, txic prducts are eliminated. Other mvements prduce the cntractin f muscles prmting gd muscle tne. Muscle fatigue and stiffness caused by ver-activity, and the resulting build-up f txic substances in the muscles, is reduced by muscular cntractin and relaxatin. Benefits t the Skeletal System The skeletal system is strengthened by using massage. Bne is indirectly affected by massage. Imprvements t the circulatin f bld and lymph in the muscles lead t better circulatin in the underlying bnes, benefiting their nutritin and grwth. Stiffness f the jints, and pains resulting frm cnditins such as arthritis, are reduced prviding cmfrt and ease f mvement. Benefits t the Circulatry System
3 The circulatry system als benefits frm the actin f massage. It takes the pressure ff the arteries and veins, accelerating the flw f bld thrugh the system prviding relief fr pr circulatin and cardiac prblems. The heartbeat strengthens, the rate f the heartbeat decreases and high bld pressure is reduced. Benefits t the Lymphatic System The lymphatic system is stimulated and the flw f lymph is accelerated thrughut the system. As the massage strkes are perfrmed, the waste and pisnus substances which have accumulated in ur verstressed bdies are rapidly eliminated. Benefits t the Respiratry System The respiratry system respnds an increased activity in the lungs is stimulated by massage. As the treatment prceeds, the breath slws and deepens. If necessary, mucus and brnchial secretins can be encuraged t leave the lungs by percussive mvements n the back and ver the lungs. Benefits t the Digestive System The digestive system benefits when massage prmtes the peristaltic activity (wave like mtin) in the cln enhancing the eliminatin prcess and cmbating cnstipatin. It strengthens the muscular walls f the intestines and abdmen, and stimulates the secretin f digestive juices frm the liver, pancreas, stmach and intestines. Benefits t the Skin The skin, bth the activity and the nutritin f the benefit frm massage. The sweat and sebaceus glands are stimulated, imprving their functin and ensuring the eliminatin f waste prducts. Skin cnditin, texture and tne are greatly imprved - the skin is healthy and glwing fllwing a treatment.
4 Massage Cntraindicatins (When nt t massage) Avid massage in the fllwing cnditins, instances and disrders: During the first three mnths f pregnancy It is generally nt cnsidered safe t massage pregnant wmen, particularly in the first trimester, when the risk f miscarriage is highest. Hwever, a gentle head massage, withut ils, is acceptable, and a light gentle, lving, strke applied t the face and brw will relieve anxiety and release stress. High temperature/fever The bdy is already fighting ff txins as indicated by the rise in temperature. A massage wuld release even mre unwelcme txins int the system. Open wunds, cuts and bruising Apply nly light tuch drainage massage arund the site, t assist the bld flw twards the heart and encurage healing where bruising is present. Oil may aggravate an pen wund. While giving a massage, cver up any pen cuts r scratches n yur hands with a plaster r ther dressing. Inflammatin Avid massage ver an area f inflammatin, (which culd be due t fatty depsits causing a cyst) and massage will spread the infectin. Hwever in case f lcalized prblems, adding a strng base f essential il t yur bath may help yu t vercme, suffering with prickly heat and redness. Inflammatin wuld include cnditins such as thrmbsis and phlebitis (painful clt in vein). Bld Clts As massage culd disldge and mve clt pssibly causing a heart attack r strke. Varicse veins, r histry f thrmbsis D nt massage ver brken r varicse veins as the bld supply is impaired in this area. Massage will increase bld flw and fld the ver-wrked capillaries and veins, pssibly causing cagulatin and affecting bld flw t the heart. Prfessinally trained therapists may effleurage gently when advised by cnsultant r general practitiner f patient. Infectius skin diseases Bacterial infectin, Lymphangitis, Fungal infectin, Viral infectins, Herpes, in these cnditins it is always advisable t get cnsent f yur medical practitiner befre having
5 massage. In case f severe skin prblems, such as eczema r psriasis - massage can add t dermal irritatin. Cancer Cancer can spread thrugh the lymphatic system, and because massage increases lymphatic circulatin, it may ptentially spread the disease as well. Simple, caring tuch is fine, but massage strkes that stimulate circulatin are nt. Always check with a dctr first. Brken bnes / Fractures Stay away frm an area f mending bnes. A little light massage t the surrunding areas, thugh, can imprve circulatin and be quite helpful. When a bne is weakened by a metastasis (spread f the cancer), deep pressure ver it may wrsen the pain r even cause a fracture. Acute back pain Avid massage, particularly if the pain shts dwn the arms r legs when the back is massaged. D nt apply massage r pressure t the spinal clumn r ther bny prcesses unless gently passing ver the area t reach ther areas f the bdy. Other chrnic cnditins and diseases Cnsult a qualified medical practitiner if yu having high bld pressure, diabetes r any heart disease prir t receiving massage therapy.
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9 William Lwe, MA WA Licensed Massage Practitiner Lic.# MA Certified Reflexlgist & Fitness Trainer Tai Chi & Qigng Instructr Office Lcated in the Heritage Building 601 Main St. Mezzanine Vancuver, WA (360) Price List f Services 1 hur Full Bdy Massage $ minute Massage $ minute Massage $ minute Massage & Reflexlgy Treatment $ hur Reflexlgy Treatment $ minute Reflexlgy Treatment $30.00 (Massages include Swedish, Deep Tissue, Trigger Pint and Medical Qigng as needed) Ht Stne Massage add $10.00 Individual Fitness Training $50 per hur. Fitness Assessment $25.00 Pathway t Fitness Prgram $240 (4 weeks meet twice per week) Onging mnthly $ Specials Buy package f 5 massages in advance and get 10% ff Schedule next massage and get 5% ff current massage Members f AnyTime Fitness receive an additinal $5.00 ff massage and reflexlgy sessins $10 ff cupn fr first massage 601 Main St. Vancuver, WA (360) Qignglmt@Gmail.cm
10 Will Lwe 601 Main St. Tel.(360) Vancuver, WA Objective: T prvide healing massage, medical qigng and fitness cnsulting in a psitive envirnment. Educatin: Internatinal Institute f Medical Qigng, Henan University f Traditinal Chinese Medicine. Medical Qigng Practitiner Certificatin Prgram currently studying with Sara Strm MMQ, LAc. Evergreen Center fr Healing Arts, Vancuver WA & East West Cllege f Healing Arts, Prtland, OR: Massage Practitiner. Washingtn State License MA Certified in Reflexlgy. Trained in Swedish Massage, Deep Tissue, Hydrtherapy and Trigger Pint. American Cllege f Sprts Medicine: Fitness Assessment Wrkshps. Certified Fitness Trainer, Expert Rating Certificatin # Pacific Christian Cllege, Fullertn, CA, Master f Arts degree, Thelgy Califrnia State University Dminguez Hills, Bachelr f Arts in Philsphy Wrk Experience: 2006 t 2010: Owner f Bdy and Sul Wmen s Fitness Center, Vancuver WA. Teaching classes in self defense, aerbics, tai chi, stress management breathing, qi gng, and karake aerbics. Prviding fitness assessments and building health and fitness prgrams fr individuals t 2006: USIS US Investigatin Services; Federal Backgrund Investigatr fr varius federal agencies and the Air Frce. Presidents Award Winner t 1998: Varius management psitins in the Mrtgage Industry including US Bank, Nrth American Mrtgage and Hmes Team Mrtgage t 1991: Teaching and Ministry psitins with Nrth American Christian Cnventin. References available upn request.
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