Brian Keith, C.M.T. Rolfing & Bodywork
Working with you to create balance in the body to optimize performance and feeling well.
Client Forms

For your initial bodywork session with me, you may complete the first-time health information either online (click on "Online Client Information Form" link) or you can click on First-Time Client Health History form to complete and print out a hard copy of the form. Clicking on the First-Time Client Health History Form will open a new window in your browser using the free Adobe Acrobat Reader.

[Note: Since this form was created with fillable fields, it may not be supported in the new window on your device. You could Open it with a Different Viewer (Adobe) or, Right-Click and save the file to your PC.] Then, you can either:

(a) complete the form on your PC or Mac. [You may save a copy of the form to your PC and save your work as you go - returning to your saved copy to continue to its completion.] Once you've completed the form, click on the "Submit" button at the lower right-hand corner of the form  [this form will be sent to me through AdobeFormsCentral.com. And, you'll most likely be prompted to "Allow" or "Trust" this site in order to send the form online.]      OR

(b) Should you have any issues getting the form, Right-Click on the Form and Save it to your device. You can either:

(i) Print out the form once completed, and bring a hard copy of the completed, printed form to me   OR

(ii) Print out the blank Health History form and complete it by hand, and bring the completed form with you.

Q: Do I have to complete the Health Form in order to get a massage?

A: Yes! All information you disclose is kept private and confidential but is an absolute requirement. The questions asked provide important information that may influence about the type of massage you receive and areas worked. And while you're under my care, I must have your identification information - both in case of an emergency and to comply with my Insurance requirements. If you're unwilling to provide the required information, please be considerate by canceling your appointment.

OTHER FORMS AVAILABLE:

Body Map for Clients


Physician's Permission form


Physician's Referral form

© Copyright 2017 Brian Keith, C.M.T. Rolfing & Bodywork. All rights reserved.