The following questionnaire is to increase your self-awareness and your understanding of massage and therapeutic bodywork.
Are you feeling stressed?
Are you irritable or moody, edgy, easily frustrated, forgetful?
Do you have back pain or grind your teeth?
Do you feel tightness in your shoulders, neck, or hips?
Did you ever have an auto accident, injury, surgery, or fall?
Are there areas where range of motion is restricted, such as shoulders, hips or knees?
Would you like a more complete recovery?
Do you use a computer?
Do you have stiff and painful shoulders, neck or back?
Do you ever experience numbness or tingling in your hands or wrists?
Do you suffer loss of grip strength in your hands?
Do you have pain in your hands or wrists?
Do you have carpal tunnel syndrome?
Do you ever have headaches?
Do you feel areas of tension in your neck or shoulders?
Are the headaches in the back or sides of the head?
Are you pregnant?
Do you experience lower back pain or discomfort?
Are you an athlete?
Would you like to improve your performance?
Do you have areas of tightness or restriction?
Do you have tennis elbow?
Do you have a pulled or strained muscle or ligament?
Have you ever suffered from trauma or abuse?
Are you uncomfortable when someone touches you?
Do you feel distressed in your body?
Would you like to experience a decrease in tension and increased feeling of safety and relaxation?
Do you have a chronic illness?
Do you have arthritis, asthma, hypertension,
chronic or acute pain, gastrointestinal problems,
immune function disorders, chronic fatigue,
circulatory problems, insomnia, or TMJ dysfunction?
Would you like to increase your feeling of overall well-being?
Would you like to try an alternative to drugs or surgery?
Are you over 55?
Do you lack exercise?
Would you like to have a greater feeling of comfort and well-being?
If you answered yes to any of these questions,
you may be benefited by massage therapy or bodywork.
One last question:
Are you alive?
Almost everyone benefits from reducing stress and fatigue,
releasing tight muscles and joints, improving circulation,
calming the nervous system, and facilitating awareness of
the mind/body connection!
Please note: If you are experiencing signs and symptoms
that are sudden, severe, or persist, consult your physician.
Website Claimer and Disclaimer: In the holistic healing model, each person is responsible for one's own health and makes one's own choices in healing. The information in this website is provided for your information and education. It is not medical advice. Any application of the information is at your own discretion. If you feel you need to do so, consult with your physician or other knowledgeable health care practitioner before or while making use of this information.
