• Home
    • About
    • Contact
  • Classes
    • Schedule
    • Pricing
  • Services
    • Reiki Energy Healing
    • Private Yoga
  • Events
    • Yoga & Myofascial Release Workshop
    • Sound Bath with Maggie
    • EFT Tapping
    • Meditative Painting
  • Retreats
    • Deep Dive - an Overnight Silent Women's Retreat
    • Find Your Flow Women's Retreat
  • Artistry
    • Custom Apparel
  • Shop
SHEER BLUE
  • Home
    • About
    • Contact
  • Classes
    • Schedule
    • Pricing
  • Services
    • Reiki Energy Healing
    • Private Yoga
  • Events
    • Yoga & Myofascial Release Workshop
    • Sound Bath with Maggie
    • EFT Tapping
    • Meditative Painting
  • Retreats
    • Deep Dive - an Overnight Silent Women's Retreat
    • Find Your Flow Women's Retreat
  • Artistry
    • Custom Apparel
  • Shop

Medical History Form

Please complete this brief medical history form, prior to your session with Kate Bruecker, LMT.
All forms will be kept confidential and used only by the practitioner in regards to your massage session. 
If you have any questions regarding the information on this form, please don't hesitate to reach out. We'll gladly guide you through, or explain why we might be asking for particular information prior to your service with us. Your health and safety is our top priority!
​Your information will be kept confidential and never shared.

    Massage Therapy - Health History Form

Submit
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Sheer Blue Artistry & Wellness

E7496 State Hwy 110 (Physical)
PO Box 559 (Mailing)
Fremont, WI 54940

sheerblueaw.com
920.915.9286 - Text Friendly!
sheerblueaw@gmail.com

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  • Home
    • About
    • Contact
  • Classes
    • Schedule
    • Pricing
  • Services
    • Reiki Energy Healing
    • Private Yoga
  • Events
    • Yoga & Myofascial Release Workshop
    • Sound Bath with Maggie
    • EFT Tapping
    • Meditative Painting
  • Retreats
    • Deep Dive - an Overnight Silent Women's Retreat
    • Find Your Flow Women's Retreat
  • Artistry
    • Custom Apparel
  • Shop