Body Solutions Inc. | Massage-intake

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Then Just Fill Out the Form Below and Gain Instant Access to Our $29.95 eBook for free!

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Complete the Form below for Immediate Access:

*We will never sell or rent your information. You will only get awesome tips and secrets from us only.

Street Address 1 *
City *
State *
Postal Code *

Cell Phone Carrier *

Emergency Contact Name *

Emergency Contact Phone *

Primary Care Physician Name

Physican phone (if unknown, name city he or she is in)

General and Medical Information
Do you suffer from any of the below?

Heart Condition *

	Yes
	No

High Blood Pressure *

	Yes
	No

Blood Clots *

	Yes
	No

Varicose Veins *

	Yes
	No

Urinary Problems *

	Yes
	No

Muscle/Joint Pain *

	Yes
	No

Nerve Pain, Tingling, Loss of Sensation *

	Yes
	No

Respiratory Problem *

	Yes
	No

Skin Problems *

	Yes
	No

Headaches / Migraines *

	Yes
	No

Herniated or Bulding Discs In The Neck Or Back *

	Yes
	No

Fibromyalgia *

	Yes
	No

General Information To Maximize Safety and Effectiveness Of Your Massage Treatment

Have you ever had a massage? If so what type? *

Are you currently pregnant? If so how far along? *

Have you previously had any surgeries? If so list where *

Are you currently under the care of a doctor? If so, list name *

Are you allergic or sensitive to any oils (nuts, scents,etc)? *

Which of the area(s) would you like the therapist to focus on? *

What are your goals for your massage therapy treatment program? *

Do you have time to perfrom recommended therapeutic exercises? *

	Yes
	No

Please follow our 24 hour cancellation policy. If you have to change your appointment please call us directly at 856-751-8881 within 24 hours of your appointment time or you will be charged the value of your scheduled massage.

Whether You are a New or Returning Client, We Guarantee You'll Leave a Happy Client!

Are You a New or Returning Client?

To Set-Up an Appointment, Complete the Form below.

Afterwards, you will receive instant access to your free eBook filled with our most effective and proven massage therapy techniques.

Schedule Your Next Massage by Visiting our Massage Appointment page now.

If you are a returning client, please select and schedule your next massage by visiting our Massage Appointment page now.

If you are a new client and want to set-up an appointment for any of our world-class massage therapy services, you must complete the form on the bottom left. Afterwards, you will receive instant access to your free ebook filled with our most effective and proven massage therapy techniques.

Within 24 hours, you will be contacted by one of our staff via email to set up your appointment.

Please note:

We ask that you stick to our 24 hour cancellation policy. If you do not cancel 24 hours before the appointment time, we will charge you for the session. *For coupon users, you would lose the value of the coupon*

If you have a question or comment, we invite you to email at info@bodysolutionsinc.com or call us at 856-751-8881. We'll be delighted to discuss our professionally directed services with you.

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Come On Down to Our Voorhees, NJ Facility For Some Much-Deserved "Pampering"!

Complete the Form Below to Receive Your Free eBook Today

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Instantly Receive Your FREE Copy of our eBook!
Optimal Blend of Massage Techniques with Medical Science!
All Programs Designed and Directed by Licensed Physical Therapists!
We Have Specific Massage Options to Suit Your Exact Needs and Lifestyle!

*We will never sell or rent your information. You will only get awesome tips and secrets from us only.

Hurry! Sign Up for Your First Massage On or Before May 21 2012 and We'll Give You ½ Off the Regular Price AND Give You Your FREE Ebook!

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That's right--just complete the form below before time runs out and one of our staff members will contact you to schedule your first massage at Body Solutions--at ½ the normal price! Plus, as an added bonus, you will also receive instant access to your FREE ebook filled with our BEST massage therapy secrets!

Offer valid only for new clients who have never experience what a truly skilled massage can do here at Body Solutions.

So don't delay and fill out the form below before time runs out to get your FREE ebook and ½ off your first massage!

*We will never sell or rent your information. You will only get awesome tips and secrets from us only.

Our schedule can be pretty booked. If you're worried about the deadline Just call us TODAY at 856-751-8881

Want to Get Your Hands On Our BEST Massage Therapy Secrets?

Massage Intake