New Client Registration Form and Code of Conduct

Our key values are giving the very best experience to our clients and making sure that the session is safe and comfortable for both the client and therapist.  We ask that you please fill out the form below so we can better get to know you and your needs.

We respect your privacy and do not tolerate spam.  We will never sell, rent, lease or give away your information (name, address, email, etc.) to any third party. Nor will we send you unsolicited email.

Today's Date *
Today's Date
Name *
Name
Can We Email You Specials? *
For a special gift!
We love to celebrate and send gifts!
Everyone should feel special :)
We'd like to say Thank You!
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Address Where Massage Will Be Performed *
Address Where Massage Will Be Performed
Preferred Date of Massage *
Preferred Date of Massage
Please list any hardware you may have (plates, bolts, screws, etc).
Emergency Contact
Name 1 *
Name 1
Please list any other medical conditions or concerns you may have here
Section
Code Of Conduct
Before receiving any services from Traveling Hands Company, it is essential that you read, agree to, and understand our policies below: I am over 21 years old. I understand that the massage given to me by Traveling Hands Company is for the purpose of stress reduction, pain reduction, relief from muscle tension, and increasing circulation. I understand that these massage services utilize cannabis oil. Although I will not feel "stoned" or experience any psychoactive effects, I acknowledge that I will refrain from operating a motor vehicle for two hours after my session ends. I understand that the massage therapist does not diagnose illness or disease and does not prescribe medical treatment or pharmaceuticals, nor are spinal manipulations part of massage therapy. I understand that massage therapy is not a substitute for medical care and that it is recommended that I work with my primary caregiver for any condition I may have. I have stated all my known medical conditions, recent surgeries, allergies, and medications, and I will keep the massage therapist updated on any changes. I understand that this is a professional service. I acknowledge that ANY sexual comments or advances will result in immediate termination of the massage. I will also be fully liable for the cost of the session. Everyone that works with our company is a highly trained professional with many years of experience. As a result, their time is valuable. I understand that I will be charged a late cancellation fee of $50 for any cancellations with less than 24 hours notice. If the therapist has been dispatched to your location and you are not there, or cancel while they are on the way, you will be billed the full amount of your service.